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3150 L~ncaster Dr. NE - Suite C <br /> Received By: -- [ Salem, Oregon 97305-1398 Date:__ _ __ <br /> Date: __ 24 HR !nspec0_'o. gJ.~ne 373~4~2~ Issued b <br /> <br /> ELECTRICAL PERMIT APPLICATION <br /> .............. ~ /~9 ~¶ ~. FEE SCHEDULE (Complete aad eat~r total i, Alb~low) <br />I ~'tease complete att e'ecrtons, 7 mrougn v 1~ ~'" <br /> Number of Inspections per p~nlt allowed <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />I I I-I '-I I I-I I I I,. <br />CROSS STRBET/~---h <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 />parkin Electric, Inc. 20250 $ Molalla Ave. <br /> <br />Oregon City, OR 97045 503-657-4958 fax: 557-1059 <br />Contractors License#: 34-4C exp. 10-01-98 <br />Supervisor: 4241-S exp. 10-01-98 <br />Contractors Board Reg #: 35151 exp. 10-12-98 <br />Metro # 2416 exp. 11-01-98 <br />Owner: <br /> <br />Supervisor License ,n ,~ S <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br /> Property Owner (please print) <br /> <br /> Mailing Address <br /> <br /> State, Zip <br /> <br /> Owner's Si~ature <br /> <br />3. PLAN REVI]EW 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 4 <br /> Each additional 500 sq. ft. <br /> or portion thereof $15.00 <br /> Limited Energy $20.00 __ 1 <br /> Each Manufactured Home or <br /> Modular Dwetling Service or Feadc, / $40.00 q~f~2 <br />B. Ser~ice~ or Feeders (Does not include branch circugs, see semion D) <br /> Installation, Alteration or Relocation <br />~ 200 amps or less $50.00 2 <br />201 amps to 4C~ amps $60.00 __ 2 <br />401 amps to 60t) amps $1 GO.00 2 <br />601 amps to 1000 arapa $130.00 2 <br />Over 1000 ~nps or volts $300.00 2 <br />Reconnect only $40.00 2 <br />C. Temporary Services~eeders <br />Installation, Alterations, or Relocation <br />200 amps or less $35.00 __ 2 <br /> <br />FEES <br />Al. Enter total of fees from Sec. g4 $ ~ <br />A2. Add 5% surcharge (.05 x Al) $ <br /> Subtotal $ <br />B. Enter 25% of lhle Al for Plan Review <br />(Sec. 3), if required $ <br />C. Investigation Fee (if required) <br />D. Reinspection Fee ($25.00) <br /> <br />Receipt No, <br /> <br />TOTAL AMOUNT DUE <br /> <br />MC 15-34 7/97 <br /> <br /> <br />