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MARION COUNTY BUILDING INSPECTION <br /> cOMMUN <br /> I 285 Churc~ St NE · Room 132 PERM T NO <br />FOR CITY V~IDATION Salem, OR 97301 <br />R~elved by:~ ] ~ D~ O' <br /> <br /> Office: ~[~:00am - 4:30pm . __ <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete ~1 Sections, I through 5.L _.. <br /> <br />1. LOCATION OF ~LATION BOILDIS$ <br /> <br />154'5.3 <br /> <br />PERMITS ARE NON-TRANSFERABLE AND EXPIRE IF WOP..K IS NOT <br />STARTED WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br /> CONTRACTOR IIqSTALLATION ONLY <br /> <br />El¢c"rlc dC°mrm°rSELEOT ELECTRIC I 371'0896 <br />Mam ^aar" 'q7q2 LIBERTY RD S #2q2.SALEM 97302 <br /> <br />C°n~cmr,' Licens': Ne' 2q-781C? <br /> <br />AB. FOR OWNER INSTALLATIONS <br /> <br />Properly Owner (pleas~ prha) <br /> <br /> Marion Co~nt~ do~s not r~quk~ a p~an ~vi~. <br /> We will provide plan review se~ice if you complete <br /> Sec~on 5B and submit two (2) sets of plans and <br /> specifications with this application. <br /> <br />MC 1~.J4 <br /> <br />Sot vlco Include: <br />10~0 sq. fl. or less $85.00 4 <br />· Ih, ch addilional 500 sq, <br /> or potllon chef*of $ I$.00 <br />Limited Energy $20,00 1 <br />Each Manufa¢lumd ltom¢ or Modular <br /> <br />E. Servi¢o~ or Flooder, (Docs not includ* branch circuits, see ~c¢',ioa D) <br /> <br /> 200 amps or I¢~ $50,00 2 <br /> 201 amps lo 400 amp~ $~).00 2 <br /> 401 amps Io 600 amps $100.00 2 <br /> 601 nnlps to 1000 nlllps $130.00 2 <br /> Over 10~0 .ntll@$ or volta $300.00 .... 2 <br /> <br />C. Tompe~ ~r y <br /> <br /> 200 amps or leis $35,00 2 <br /> 201 amps Io 400 amps $40.00 2 <br /> 401 rands to 600 amps $80.00 2 <br /> Over 600 amps or 1000 <br /> <br /> a) The fee £or branch circuim <br /> <br />E. Miaoellanooua (Se. rvioo or Feeder NiX Included) <br /> Each pump or irrigation <br /> Each sign or oultino li~ling <br /> Signal circuR(s) or ~ Ihnllod ~n~ <br /> <br /> Pack of 10 hbds ~ $5.~ <br /> (sold only to *l~tri*M ~ontractorO <br /> <br /> O~ required bg Building <br /> Aumm Dwelling Elec~icn] Fcc <br /> Dwdli,g Pennil Label ~ ot~bels. <br /> <br />$35.00 <br />$ 2,00 <br /> <br />$40.00 <br />$4.O.00 <br /> <br />$40.00 <br /> <br />$50.00 <br /> <br />N/C <br /> <br />B. E. Ler 25% o1' lin0 Al for Plan R~vlow <br />(Sec, 3), ii'required $.__ <br />C. Investigation F~,~ (if required) <br />D, Rei.sp~ction F¢,.~ ($25.00) $.__ <br /> <br /> TOT~ mO~ DUg <br />Recclp~ No. <br /> <br />5. FEES <br /> <br /> A2, Acid 5% ~umharg~ (.05 x Al) <br /> Subtotal $.__ <br /> <br /> <br />