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ITY VALIDATION <br /> <br /> y: <br /> <br /> MARION COUNTY <br />BUILDING INSPECTION DIVISION <br />3150 Lancaster Dr. NE - Suite C <br /> Salem, Oregon 97305-1398 <br /> <br /> 24 HR Inspection Line 373-4427 <br /> Omce: phone $88-5147 8:00am. 4:30pm <br /> FAX 588-7948 <br /> <br />ELECTRICAL PERMIT APPLICATION / <br />Please complete all Sections, 1 through 5 <br /> <br />1. LOCATION OF INSTALLATION <br /> <br /> TAX ACCOUNT NO. <br /> <br /> JOB ADDRESS <br /> <br /> CITY <br /> <br />CROSS STREET/ <br />DIRECTIONS <br /> <br />PROIECT DESCRIPTION <br /> <br />PERMITS ARE NON-TRANSFERABLE AND EXPIRE IF WORK IS NOT <br />STARTED WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br />Electrical Contractor <br /> <br /> Mailing Address City <br /> <br />Contractor Board Reg No. <br />Supervisor License <br /> <br /> Signature of Supv. Electrician <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br />Property Owner (please print) <br /> <br />3. PLAN REVIEW 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 />PERMIT NO: <br /> <br />Date: <br /> <br />Issued by: <br /> <br />4. FEE SCHEDULE (Completa and enter total in Al below) <br /> <br />$85.00 -- 4 <br /> <br />Installation, Alteration or Relocation <br />200 maps or less $50.00 2 <br />201 maps to 400 amps $60.~0 2 <br />401 maps to 600 amps $100.00 2 <br />601 amps to 1000 amps $130.00 2 <br />Over 1000 amps or volts $300.00 2 <br />Reconnect only $40.00 2 <br /> <br />5. FEES <br /> <br />B. Enter 25% of line Al for Plan Review <br /> <br /> f required) <br />D. Relnspecllon Fe~ ($25.00) <br /> <br />Receipt No.__ <br /> <br />Su~oral $ <br /> <br />TOTAL AMOUNT DGE <br /> <br />MC 15-34 7/97 <br /> <br /> <br />