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FOR OFFICE USE ONLY <br />Received by:. <br />Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br />PERM1TS ARE NON-TRANSFERABLE AND NON-REFUNDABLE AND <br />~IRE ~F WORK IS NOT STARTED ~ 180 DAYS OF ISSUANCE <br />OR IF WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />lB. FOR OWNER INSTALLATIONS <br />property Owner <br /> <br />Mal~g Address Phone <br /> <br />City/State/Zip <br /> <br />The Lnstallafion is being made on property I own winch is n(X intended for sale, <br /> <br />'Owners Signature <br /> <br />3. PLAN REVIEW SECTION <br /> <br />We will provide plan review service if you complete Section <br />5B and submit two (2) sets of plans and specifications 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 />MC 15-34 11/91 <br /> <br /> 220 High Street NE <br />Salem, Oregon 97301 <br /> <br />BUILDING I} l~ffiaznmz (Complete and enter total in A ! below) <br /> <br /> Number of Inspections per pemlt allowed -~ <br />A. <br /> ReMdentlal <br /> Per <br /> Unit <br /> / <br /> Service Incladed: Items Cut (each) Sumi <br /> 1000 sq. ft or less $85.00 4 <br /> Each additional 500 sq. ft. <br /> or go.on thereof $15.00 <br /> ~ Fme~gy $20.00 -- 1 <br /> <br /> Each Manufd Home or Modular <br /> Dwelling Sevde~ or Feeder $40.00 <br /> <br />B. b~rvlC~ or F~rs (Does not inleade heaneh~circfii~ s~e section D) <br /> Installation, Alterations or Rsiocation <br /> <br /> 201 amps to 400 amps <br /> 401 aml~ to 600 amps $~00.00 <br /> 601 amps to 1000 amps $~0.00 <br /> Over 1000 amps or volts $300.00 <br /> Recov. uect ~y $40.00 <br /> <br />C. Temporary Services/Feeders <br />Installation, Alteration, or Relocation <br />200 amps or less $35.00 <br />201 maps to 400 amps $40.00 <br />401 amps to 600 amp~ $80.00 <br />Over 600 amps or 1000 volts <br />se~ "B" above <br /> <br />D. Branch Circuits <br /> New, Alteration, or Extension Per Panel <br /> <br /> a) The fee for branch cit~alts with <br /> p~rchase of semlc~ or feeder fee <br /> <br /> Each branch circuit $2,00 <br /> <br /> b) The fee for branch circuts withou[ <br /> ouvehase of se~x4ce or feeder fe~ <br /> First branch circuit ] $88.00 <br /> Each additional branch cin:uit ~ $2.00 <br /> <br />E. Mlseellaneoas ($ervlee or Feeder Not Included) <br /> Each p~mp or irfigafic~ circle - $40.00 <br /> Each sign or outline Eghting $40.00 <br /> Signal clxcuit(s) or a limiwat energy <br /> panel, alteration or extension $~0.00 <br /> <br />E Each additional lnspeetlo~ <br />over Ihe allowable in any of ~be <br />above, ~ Inspectioa $35.00 <br /> <br />G. Minor Installation Labels <br />Feek of 10 labels @ $5.00 each $50.00 <br />(sold only to electrical contractors) <br /> <br />H. Other <br /> (As required by Building Official) <br /> <br />5. FEES <br />Al. Enter tc4al of fees from Sec. #4 $ ~ <br />A2. Add 5% surcharge (.05 x A 1) $ _ <br /> <br /> Subtotal $ <br /> <br /> B. Enter 25% of line A1 for Plan Review <br /> (Sec. 3),if re~tuired $ <br /> C. lnvesfigafionFee (ff required) $ <br /> D. Reinspection Fee ($25.00) $ <br /> TOTAL AMOUNT DUE $ 7c{'75' <br /> <br />Receipt No. <br /> <br /> <br />