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FOR CITY VALIDATIONI <br />Received By: I <br />Date; I <br /> <br /> MARION COUNTY <br />BUILDING INSPECTION DIVISION <br />3150 Lancaste~ Dt I,~ - Suit~ C <br /> Salem, Oregon 97305-1398 <br /> <br /> 2.4 HR Inspeclion Line 373.4427 <br /> OfFice: phone 588-5147 $:00am - 4:30pm <br /> FAX 588-7948 <br /> <br />ELECTRICAL PERMIT APPLICATION <br />P/ease comp~ere al~ Sections, 1 through 5 <br /> <br />1. LOCATION OF INSTALLATION <br /> <br /> CROSS S~ET/ ~1 <br /> <br /> ~S ARE NON~NS~BLE A~ ~1~ IF WO~ IS NOT <br /> STARED WI~ 180 DAYS OF ISSU~CE OR ~ <br /> WO~ IS SUSP~D~D FOR 180 DAYS, <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />2B. FOR OWb ER INSTALLATIONS <br /> <br />I Pcopeaxy Owner (please print) <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 />PERMIT NO: <br /> <br />Date: <br /> <br />Issued by: <br /> <br />4. FEE SCHEDULE (Complete and enter total in A1 below) <br /> <br />$85.00 4 <br /> <br />$15.00 <br />$20.00 I <br /> <br /> Installation, Alteration or Relocation <br /> 200 amps or less <br /> 20t amps to 400 amps <br /> 40l amps to 600 amps <br /> <br />C. Temporary Services/Feeders <br /> <br />$35.00 2 <br />$40,00 2 <br />$80,00 2 <br /> <br />$2.00 <br /> <br />$35.00 <br /> $2.00 <br /> <br />$35.00 <br /> <br />$50.00 <br /> <br />sq. ft. x $.065 = __ <br /> <br />N/C <br /> <br />5. FEES <br /> <br />B. Enter 25% of line A l for Plan Review <br /> (Sec, 3), if requirod <br />C. Investigation Fee (if requited) <br />D. Reinspeetion Fee ($25,00) <br /> <br />Receipt No. <br /> <br />Subtotal <br /> <br />TOTAL AMOUNT DUE <br /> <br /> <br />