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FOR OFFICE USE ONLY <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br />Received by: 220 High Slrcet NE <br /> ' Sa~m, Oregon 97301 <br />Date: <br /> Phona 5~-5147 8:00 am y4:30pm <br /> C. cde-A-Phor~ 588.//904 <br /> <br /> Pl,,~$o cOmploto dl $ocgon$, ~ through <br /> <br /> MARION COUNTY <br /> L LOCATIONOFINSTALLATION .,,. m.~. IM.RP[ }TII <br /> <br />PF.~MII~ A~E NON-TRANS FERABI~ AND NON-RI~UiN'DABLE AND <br />EX~IRll ~F WORK IS NOT STAI~i'~O ~ 180 DAYS OF ISSUANCE <br />OR ]F WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br /> HC~I~t%TELL · [ptu~e 968-3353- <br /> <br />Conu~or's Bo,~ Reg. No. 57824 <br /> <br />2B. FOR OWN'ER INSTALLATIONS <br /> <br />Propsrry Owner <br /> <br />bl~ling Address <br /> <br />Phone <br /> <br />City/State/Zip <br /> <br />, T~ imtallafioa is being made on prop:reft I own which is ~x intended for <br /> <br />Owner's Signature <br /> <br />3. PLAN REVIEW SECTION <br /> <br />We will provide plan review service if you ~omplete Section <br />5B and submit two (2) sets of plans and specifi~il°ns with <br />this application. , <br /> <br />This optional plan review program does not suspend the <br />required submission of lighting power calculations, plans, <br />and specifications when required by the Oregon Structural <br />Specialty Code, Chapter 53. <br /> <br />SITE #: C/ Permit No: <br /> <br />Date: <br /> <br />Issued by: <br /> <br />iN4. FEESCHEDULE (Complete and cm~tto~in Al bcinw) <br /> Number of Inspections per permit allowed -- <br /> <br />A. Residential Per Unit <br />Service Included: Ya~m.s Cost (~ch) Sum <br /> <br />1000 sq.~ orless $85.00 -- 4 <br />Each ~fional 50(I sq. fi. <br />o~ gonlca3 Ihemof $15.00 <br /> <br />Each Ma~ufd Home or Modular <br />Dwelling Sendce or F~d~ $40.00 __ 2 <br /> <br />g. Set,rices or Feeders (Docs not hdcu& br~ach ci~cuiu, sea scion <br /> Installation, Alt~ations or Rdoeatinn <br /> <br /> 201 amps to 400 amps $~0.00 2 <br /> 401 amps to 6~0 amps $ ~00.00 2 <br /> 601 amgs to 11~00 amps $130.00 2 <br /> Over I000 amps or vol~ $.300.~0 2 <br /> ~a ~ly $40.00 2 <br /> <br /> C. Temporar7 ServicestFeeclers <br /> Installation, Alteration, or Relocation <br /> 200 amps or less $~5.00 2 <br /> 201 amps to 400 amps $40.00 __ 2 <br /> 401 ,~nps to 600 amps $80.00 -- 2 <br /> Ova600 amps or 1000 volts <br /> <br /> D. Br:mch Circuits <br /> New, Altsrations or Exteasinn Per l~nel <br /> <br /> vurchase of seodc~ or feeder fee <br /> Each branch cltcuit $2.00 <br /> <br /> b) Th~ fe~ for bnnch 6rc~s.w~thout <br /> vurchase of servic~ or fe~d~ fee <br /> <br /> Fu-st branch cis'~k $35.00 <br /> Each addi~onal branch c~mit $2.00 <br /> <br /> E. Miscellaneous (Service or Faader No~ I~duded) <br /> Each psmp 0~ in:,gn~ca ciscl~ $40.00. <br /> ~¢h sign or euttina lighting $40.00 __ <br /> Signal c~cult(s) or a lirrfited ane3~y <br /> panel, alteration or exteasinn I $40.00 <br /> <br /> F. Each additional l~pa~tim~ <br /> ov~ th~ allowable i~ any of <br /> above, l~r Inspect;on $35.00 <br /> <br /> G. Minor Installation Labels <br /> Pack of 10 label~ @ $5.00 ~ach $50.00 <br /> (~old only w d~ctrinal eontractom) <br /> <br /> H. Other <br /> ( A~ requ~rtd by Building Official) <br /> <br />5. FEES { '~ <br /> Al. Emer tc~al of fe~s from Set- #4 <br /> AY.. Add 5% sm'charge $05 xAl) <br /> <br />Subtotal <br /> <br />B. En~r 25% of linc Al for P~n Review <br /> (Sec. ~),if mqulzod <br />C Investigntinn P~e ('ff ~) <br />D. R~inspe.~io~ Fe~ tS25.00) <br /> <br />TOTAL AMOUNT DUE <br /> <br />,$ <br /> <br />s <br /> <br /> <br />