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MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> FOR V/~I-,~ 285 Church St NE · Room 132 <br /> <br />I 'l <br />~ , Office: Pho~[~am - 4:30pm <br /> <br />£L£GT~IGAL PERMIT APPI_IOATI~)~-- <br />[ Ploaso oora loto att 8oaOon$, I througl 5 o <br /> <br />PERMIT NO: <br />Date: <br /> <br />Issued by: <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />Job Address <br /> <br />Cross StreeffDireciiom: <br /> <br /> PERMITS ARE NON-TRANSFERABLE AND EXPIRE IF WORK IS NOT <br /> STARTED W1THN4 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPI~DED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />Electrical Contractor <br /> <br />Phon~ Fp~ho~neg <br />Property Owner <br /> <br />Contractor's Board Reg No. <br /> <br />Signature of Sut~ralsi Eleatician <br />Su_~rvisor's License No. <br /> <br />I lob No. <br /> <br />FOR OWNER INSTALLATIONS <br /> <br /> 3. PLANRBVIBW SECTION <br /> <br /> Marion County does not rexluim a plan review. <br /> We will pwvide plan review service if you complete <br /> Section 5B and submit two (2) sets of plans and <br /> specifications with this application. <br /> <br />MC 15-341/96 <br /> <br />l~E SCHI/DULE (Complete and enter tulal in A t below) <br /> Number of lnspo~6ons per p~rmit allowed <br /> <br /> ltums Cost (e~h) Sum <br /> <br />1000 sq. fl. or less $85,00 4 <br />Each additional 500 sq. ft. <br /> or portion thereof $15,00 <br />Limited Enexgy $20.00 1 <br />Each Manufactured Home or Modular <br />Dwelling Service or Feeder [ $40.00 ~ <br />B. S~vices or Feeders (Doe~ not include branch circuits, see section D) <br /> ]~allation, Alteration o~ Rdoeatio~ <br /> ~00 amps or ]~ $50.00 -- 2 <br /> 201 amps to 400 amps $60.00 -- 2 <br /> 401 amps to 600 amps $100,00 2 <br /> 601 amps to 1000 amps $130.00 -- 2 <br /> O~er 1000 amps orvolts $300,00 -- 2 <br /> Reconnect only $40.00 -- 2 <br /> <br />~. T~nporsry Servlce~Feede~s <br />Installation, Alteratloo, or Relooation <br />200 amps or les~ $35.00 -- <br />201 amps to 400 amps $40.00 -- <br />401 amps to 600 amps $80.00 -- <br />Over 600 amps or 1000 volts <br />s~e "B" above <br />D. Branch Circuits <br />New, Alterations, ~r Extension Ea~ Panel <br />a) The fee for branch circuits ~ <br />purchase of service of fe~der fee <br />Each branch circuit $ 2.00 -- <br /> <br />$35.00 <br />$ 2.oo <br /> <br />N/C <br /> <br />E. Miae~ll~n~ous (Service cr Feed~ Not lnoluded) <br />Each pump ~ i~gat~n oi~l~ ~.00 <br />~ch al~ or oufline li~t~g ~.~ <br />Signal cig~t(s) or a I~i~ <br />p~el, aiterafi~ or ex.ion ~.00 <br /> <br /> a~ve, ~r lmp~otion $35.00 <br /> Pack of 10 labob <br /> <br /> (~ required by ~it~ O~ciaO <br /> Aurora Dwelling El~ffieal <br /> <br />Subtotal <br /> <br />5. FEES <br /> A 1. Enter total of fe~ from Sec. <br /> A2. Add 5% sumharge (.05 x A 1) <br /> <br />2 <br />2 <br />2 <br /> <br />2 <br />2 <br /> <br />2 <br /> <br />B. Enter 25% of line A 1 for Plan Reviow <br /> (Sec. 3), if r~quired <br />C. lnv~tigation r~e (if required) <br />D. Reinspection Fee ($25.00) <br /> <br /> TOTA A OU DU" S <br />Receipt No. <br /> <br /> <br />