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~R CITY VALIDATION <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complet& all Sections, 1 through 5 <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 /> Off'l~e: phone 588-5147 8:00am - 4:30pm <br /> ~ FAX 588-7948 <br /> <br />1. LOCATION OF INSTALLATION <br /> <br /> I I I-Ill I-I I I I <br /> CROSS S~ET/ <br /> D~CTIONS ~ <br /> PROIECT DESC~ON <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 /> <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 />SeC'tion 5B and submit two (2) sets of plans and <br />specifications with this application. <br /> <br />MC 15-34 7/97 <br /> <br />PERMIT NO: <br /> <br />Date: <br /> <br />Issued by: <br /> <br />4. FEE SCHEDULE (Complete and enter total in Al below) <br /> <br />A. Residential Per Unit <br /> Service Included: <br />1000 sq. ft. or less <br />Each additional 500 sq. ft. <br /> or portion thereof <br />Lind~od Energy <br /> <br />Each Manufactured Home or <br />Modular Dwelling Service or Feeder <br /> <br />$85,00 4 <br /> <br />$15.00 <br />$20.00 <br /> <br />$40,00 <br /> <br />B. Services or F~'ders (Does not include branch circutis, see section D) <br /> <br />Installation, Alteration or Relocation <br />200 amps or less $50.00 ~ 2 <br />201 amps to 40? amps $60.00 __ 2 <br />401 amps to 600 amps $1~0.00 <br />601 amps to I000 amps $130.00 __ 2 <br />Over 1000 amps or volts $300.00 2 <br />Reconnect only $40.00 __ 2 <br />C. Temporary Services/Feeders <br />Installation, Alterations, or Relocation <br />200 amps or lass $35.00 __ 2 <br />201 amps to 400 amps $40.00 -- 2 <br />401 amps to 600 amps 880.00 __ 2 <br />Over 600 amps or 1000 volts see "B" above <br />D. Branch Cireulls <br />New, Allaration, or Extension Per Panel <br />a) The fee for branch circuits ~ <br />nurchase of service or feeder fee <br />Each branch circuit $2.00 <br />b) The fee for branch circuits without <br />~urchase of service or feeder fee <br />First branch circuit $35.00 <br />Each additional branch chrcug $2.00 <br /> <br />E. Mis~ellaneons (Service or Fe~der Not Included ,CY,~) <br /> <br /> Each sign or outline lighting $40.00 2 <br /> Signal circuit(s) or a limited energy <br /> panel, alteration or extension ~ $40.00 __ 2 <br /> <br />F. Each additioanl lnspeellon <br /> Over the allowable in any of the <br /> above, per Inspection $35.00 <br /> <br />G. Minor Installation Labels <br /> $50.00 <br /> <br />sq. ft. x 5.068 =__ <br /> <br />FEES <br />Al. E~ter total of fees from Sec. 04 <br />A2. Add 5% surcharge C05 ~c Al) <br /> Subtotal <br /> B. Enter 25% of line Allot Plan Review <br /> (Sec. 3), if required <br /> C. lavestigation Fee (if requLred) <br /> D. Rehmpect ion Fee ($25.00) <br /> TOTAL AMOUNT DUE <br />Receipt No. <br /> <br /> <br />