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"1 ' I BUILDING INSPECTION DIVISION PERMIT NO' ~'%'O~,,~{~ <br /> FOR CI~ V~IDATION a~0 L~ter ~. ~- Suite C ' ~ <br /> <br /> - . ~ I S~e~ Oregon 97305-1398 ~ <br /> ~e~iveo ~y: ~ [ Date:~ ~ <br /> <br /> Date: 24 HR~ ~7~427 <br /> ~l om~: pho~ ~m ~ 4:a0pm ISSU~ by: <br /> PleaseELECTRICAL PERMITa/i APPLICATIONF PR 1SC BVLE -- <br /> ] . . (Compile ~d enter wml in A1 ~1~) <br /> <br /> (~h) <br /> 1. LOCATION OF ~ST~LATION ~ ~. ~. or ]¢~ *a~.00 __~ <br /> <br />JOBADDRESS oO7~.~f 6--O~-e <~'a~5 ,~q <br /> <br />PROPERTY OWNER <br /> <br />CROSS STREET/ <br />DIRECTIONS <br /> <br />I <br /> <br />STARTED WITHIN 180 DAYS OF ISSUANCE OR IF <br />WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />Electrical C°nh~aet°r .~' l.--t.,. I Pt,~ ~/~f <br />Mailing Address f~.~., ad X '{~ t 7 City 5 <br />Pho.e <br /> <br />FAX 5" f~ g -- '7 L;q -- ~, <br /> <br />Con . tor No. oc <br />Supervisor License l ,Z'3 '~ ~, S <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br /> Property Owner (please print) <br /> <br /> Mailing Address <br /> <br /> City, State, Zip <br /> <br /> Owner's Signature <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 />MC 15-34 7/97 <br /> <br />Each additional 500 sq. ff. <br /> or portion thereof $15.00 <br />Limitod Energy $20.00 <br />Each Manufactured Home or <br />Modular Dwelling Service or Feodea' $40.00 <br /> <br />B. Services or Feeders (Does not inalude branch circuits, see ~tion D) <br /> <br /> Installation, Alteration or Rel~ation <br /> 200 am!~ or less $50,00 2 <br /> 201 am!~ to 400 am!~ $60.00 2 <br /> 401 amps to 600 amps $100.00 2 <br /> 60 [ aml~ to 1000 ~ $130.00 __ 2 <br /> Ov~r 1000 amps or volta $300.00 __ 2 <br /> Reconn~t only $40.00 2 <br /> <br />C. Tempora~ Services/Fcoder~ <br />200 amps or less [ $35.00 "~ ~"~ 2 <br /> 201 amps m 400 amps $40.00 2 <br /> 401 amps t~ 600 amps $$0.00 2 <br /> Over 600 amps or t000 ,,olta see "B" above <br /> <br />D. Branch Circ~ita <br /> New, Alteration. or Extension Per <br /> <br /> Each brach circuit ~- ~ $2.00 <br /> <br /> Each pump or irrigation circle $40.00 2 <br /> Each sign or outline llght i~g $40,00 2 <br /> Signal circuit(s) or a limited energy <br /> <br />B. Enter 25% of line A I for Plan Review <br />(Sec. 3), if required $ <br />C. lnvmigafion Fee (if requital) <br />D. Reinspection F~e ($25,00) $ <br /> <br />Receipt No. __ <br /> <br /> <br />