Laserfiche WebLink
FOR CITY VALIDATIONI <br />Received by: <br />Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br />COMMUNITY DEVELOPMENT CENTER <br />285 Church St NE · Room 132 <br /> Salem, OR 97301 <br /> <br />r ELECTRICAL PERMIT APPLICATIO it iU[ <br /> <br /> 24 Hr lnspectioa Line.' 588-7904 <br />OfF. e: 588-5147 8:00a.m.-4:30p.m. <br />FAX: 588-7948 <br /> <br />PERMITS ARE NON-TRANSFERABL~ AND EXPIRE IF WORK l~ NOT <br />STARTED WITHIN 180 DAYS OF ISSUANC~ OR IF <br /> WORK IS SUSPEI~IDED FOR 180 DAYS. <br /> <br />CONTRACTOR INSTALLATION ONLY <br /> <br />2B. FOR OWlq]SR INSTALLATIONS <br />l~operty Owner ~le~prim) <br /> <br />Mailing Address I Phon~ <br />CiiylStatedZip <br />Owner's Sigflatur¢: <br /> <br />3. PLANREVItlW SIICTION <br /> <br /> Marion County does not require a plan review. <br /> We will provide 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 15-34 12/94 <br /> <br />la~ued by: <br /> <br />4. ~!1 ~lC~ HI)[t'-L~ (Ce~plete attd em~ ~1 ~ Al <br /> <br />~ R~ident~l P~ ~n~ N~of~t~ ~it al~ ~ <br />~v~ Ifl~dd: lle~ Cmt (~h) Sum <br />1~ sq. ~. ~ less $85.~ 4 <br /> <br />~i~ ~ ~0.~ 1 <br />~ ~ufacm~ H~ or Mo~ <br />~ling ~ic~ or ~ ~.~ <br /> <br />· ~ ~ ~s (~s not ~clu~ ~ch ci~uit~ s~ ~on D) <br /> <br />200 ~-n0~ or le~s $50.00 2 <br />201 ~nt~ to 400 amp~ $60.00 2 <br />~l am~ m ~ ~ $1~ 2 <br />~1 ~ ~ I~ ~ps $1~.~ 2 <br /> <br />~n~ct o~y ~ 2 <br /> <br />~ ~ or le~ $35.~ 2 <br />~1 m~ to ~ ~ $~.~ 2 <br /> <br />a) ~o foe for brach c~ffi~ ~ <br />~ch ~nch c~uit $ Z~ <br /> <br /> 2 <br /> 2 <br /> <br /> 2 <br /> <br /> b) The fee fo~ branch circuits without <br /> <br />B. Miwdlanemas (Se~vi=e ~- Feede~ N~ Included) <br /> <br /> Each sign or outline lighling <br /> 8iga~ circuit(s) or a limited en~gy <br /> <br />~n. Rae, h additional <br /> Ovgr rig allowable in any of <br /> <br /> Pack of 10 labels ~ <br /> <br />H. Oth~ <br /> (As r~quired by Buildiqg O~ciM) <br /> <br /> I~/el ling P~tmit Label <br /> <br />$35.00 <br /> <br />S50.00 <br /> <br /> ~l. L x $.06 =__ <br />f/of Labels N/C <br /> <br />PEE8 <br /> <br />Al. Enter totaloffees from Sec.//4 <br />A2. Add 5% sur;ha~e (.05 x Al) <br /> Subtotal <br /> <br />B. Enl~r 25% of line Al for Plan Roview <br /> (SUe. 3), if r=quirod <br />C. investigation Fee (if required) <br />D. Reinapection Fee ($25.00) <br /> <br /> TOTAL A/VIOUNT DUE <br /> Receipt No. <br /> <br />$ <br /> <br />$ <br />$ <br /> <br /> <br />