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MARION COUNTY BUILDING INSPECTION <br />COMMUNITY DEVELOPMENT CENTER <br /> <br />FOR CITY V~ 285 ChUmhsalem,StoRNE97301- Room 132 PERMIT NO: <br />Received by:~ I <br />Date:__ J 24 Hr Inspection Line: 588-7904 Date: <br /> Office: 588:5_14'~.~;RlI~..m.-4:30p.m. . ~ L <br /> <br /> Please complete all Sections, I through 5 ~ilIR 2 3"~ )§. FES SCHEDULR (Complete and e,t~ totalln Al below) <br />L LOCATION OF INSTALLATION ~lli~'0" C0~ ~R.ideatialP~Uai, Hanl~rot'Im lpe~ti~Sp~oap~(mi'tac~OWs~dm----~ <br /> <br />ci~ b4 ff' c~ s~ <br /> <br />4 <br /> <br />1 <br /> <br />2 <br /> <br />I~RMITS A~d~ NON-TRANSFERABLE AND EXPIRE IF WORK IS NOT <br />STARTED V~TrHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />CONTRACTOR INSTALLATION ONLY <br /> <br />2B. FOR OWNER INSTALLATIONS <br />Property Owner (ple~seprir~) <br /> <br /> T <br />Mailing Address [ Phone <br /> <br />City/State/Zip <br /> <br />3. PLAN RBVIEW SECTION <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 /> $85.00 -- <br />Each additional 500 sq. ft. <br /> or 0ortion thereof $15.00 -- <br />Limited Energy $20.00 -- <br />Each Manu factored Home or Modular <br /> <br /> 601 amps to 1000 amps $130.00 -- <br /> Reconnect only $40.00 -- <br /> <br /> 200 amps or less $35.00 -- <br /> <br />2 <br />2 <br />2 <br />2 <br />2 <br />2 <br /> <br />2 <br />2 <br />2 <br /> <br />$35.00 <br />$ 2.00 <br /> <br />E. Mi~o~llan~ous (8~rvie~cr F~l~r Not Include) <br />~ch pump or i~gation cigle $~.~ 2 <br />~ch si~ or ou~ine light~g $~.~ 2 <br />Sig~ ciguit(s) ora limit~ en~ <br />p~el, alt~a~on or exgmion $~.~ 2 <br /> <br /> ~er the aUowable in any of ~e <br /> ~, per ~pect~n $35.~ ~ <br /> <br /> Pack of 10 labe~ ~ $5.~ ~ch $~.~ ~ <br /> (~ required by Buil~ O~eial) <br /> <br />5. FEBS <br /> A L ~anter total of fe~ from Sec. #4 <br /> A2. Add 5% surehacg~ (,O~x Al) <br /> <br />Subtotal <br /> <br />B. Enter 25% of linc A1 for Plan Review <br /> (Sec. 3), if required <br />C. Investigation ~ 6frequimd) <br />D. Reimp~¢tion Fag ($25.00) <br /> <br /> TOTAL AMOUNT DUE <br /> Receipt No. <br /> <br />MC 15-34 12/94 <br /> <br /> <br />