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FOR CITY VALIDATION [ <br />Received by:. <br />Date: <br /> <br />MARION COUNTY BUILDING INSPRCTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> <br /> Date: <br /> <br /> 24 Hr Inspection Line: 588-7904 <br />Office: <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete all Sections, I through 5 <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />PERMITS AR~ NON-TRANSFERABLE AND EXPIRE IF WORK IS NOT I <br /> STARTED WITH1N 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR IS0 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />Electrical Contractor I Phone <br />Mailing Address <br />Property Owner [ Phone <br />Contractor's License No. <br />Contractor's Board Reg. No. { lob No. <br />Signature of Supervising Electrician <br />Supervisor's License No, ] Phone <br /> <br />2B, FOR OWNER INSTALLATIONS <br /> <br />IvhilingAddr~ g I ~ t-] &t La~t~ I~h°~?g.,~7?7 <br />City/State/Zip ~.¢Dr& <br />Owner's Signat~r~: <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 />58g~.~8:00g- 4:30 p.m. Issued lay: <br /> <br /> ' .~ ~EE SCI-I]i]DULi~ (Complete and ~t~ to~l M Al ~low) <br /> <br /> ~ less $85.~ 4 <br /> <br />or portion thereof $15.00 <br />Amited Energy $20.00 1 <br />Each Manufactured Home or Modular <br />Dwelling Service or Feeder $40.00 2 <br /> <br />BT 8~v~e~/~ ~d~ ~ffot in~IuOo lmmglx eire~g~, ~ ~/.on D) <br /> <br /> 200 amps or <br /> <br /> ~1 amps tu <br /> <br /> Recon~t only <br /> <br /> 2~ am~ or le~ <br /> 201 amps to ~0 amps <br /> ~1 amps to ~0 amps <br /> <br />O. Branch Cireults <br /> <br /> a) %e fee for br~h oigui~ <br /> umh~e of semite of fe~er <br /> <br />b) ~he fee for branch cimuita without <br /> numhaae of service or feeder fee <br />First branch circuit <br />Each additional branch circuit <br /> <br />$50.00 .C~.' ~ <br />$60.110 2 <br />$100.OO __2 <br />$130.OO __2 <br />~O0.OO 2 <br />.$40.00 -- 2 <br /> <br />E. Miscellaneous (Servieeor Feeder Net Inehded) <br />Each pump or in-igation circle $40.OO -- <br />Each sign or outline lighting $40.OO -- <br />Signal circuit(s) or a limited energy <br />panel, alteration or extension $40.00 -- <br />F. Each additional Inspection <br />Over the allowable in any of the <br />above, per Inspection $35.00 -- <br />~. Miner Installation Labels <br />Pack of 10 labels @ $5.00 each $50.00 -- <br />(sold only to electrical <br />H. Other <br />(As required by Buila~ag OITtci~O <br /> Aurora Dwelling Electrical Fee __.sq. ~. it $,06 = -- <br /> Dwelling Permit Label # of Labels. <br /> <br />$35.00 2 <br />$4O.OO -- 2 <br />$80.OO 2 <br /> <br />$ 2.OO -- <br /> <br />$35.OO <br />$ 2.OO -- <br /> <br /> 2 <br /> 2 <br /> <br /> 2 <br /> <br />Al. Enter total of fees fwm $~c. #4 <br />~. Add 5% surcharge (.05 x Al) <br /> ~btotal <br /> <br />B. Enter 25% of line Al for Plan Review <br /> (S~. 3), if gqMgd <br /> <br />D. Rei~peetion Fee ($25.~) <br /> <br /> TOT~ ~O~ <br /> Receipt No. <br /> <br />MC 15-34 12~4 <br /> <br /> <br />