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FOR CITY VALIDATION[ <br />Received by:. <br />Date: <br /> <br />MARION COUNTY BUILDING INSPBCTION <br /> <br />COMMUNITY DEVELOPMENT CENTER <br />285 C~urch St NE · Room 132 <br /> Salem, OR 97301 <br /> <br /> 24 hr. lnspe~ion Line 373-4427 <br />Office: Phone 588-5147 8:00am. 4:30pm <br />FAX: 588-7948 <br /> <br />IELECTRICAL PERMIT APPLICATION I <br />Please complete all Sections, I through 5 <br /> <br />1. LOCATION OF INffrALLATION <br /> <br />Directions <br /> <br />PERMITS ARE NON-TRANSFERABLE AND EXPIRE IF WORK 15 NOT <br />STARTED ~ 1~0 DAYS OF ISSUANCE OR Ha <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />2A. COHTRACTOR IHb-'TALLATION ONLY <br /> <br />9.11. FOR OWNt~R INSTALLATION8 <br />Property Owner ~o/e~s~ print) <br /> <br />Mailing Addr~z <br /> <br />City/State/Zip <br /> <br />Ow~r's Signature: <br /> <br />3. PLANREVIBW SBCTION <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 />Date: <br /> <br />Issued by: <br /> <br />4. FI~B SCH]~DULE (Complete and enter total in Al below) <br /> Number of lmlnCliona per permit allowed <br />A. <br /> Residential <br /> per <br /> Unit <br />5orvie~Ineluded: Items Cost(ench) Sum t <br />1060 sq. ft. or less $85.00 4 <br />Nach additional 500 aq. fL <br /> ce portion thereof $15.00 <br />Limited Energy $20.00 1 <br />Bnch Msaufaetured Home or Modular <br /> Dwelling Service or Feede~ $40.00 2 <br /> <br />B. 8ec6ees ct F~lees (Does not include branch citcni~, aec a~lion D) <br /> <br /> 201 ~rnl~ to 400 nmp~ $60.00 <br /> 401 aml~ to 600 ~m~ $100.~0 <br /> 601 amp~ to 1000 ~rap~ $1~0,00 <br /> Owr 1000 amp~ or veils $300.00 2 <br /> Reconnect only $40.00 2 <br /> <br /> 200 amps or leas $35,00 __2 <br /> 201 aml~ to 400 amps $40.00 2 <br /> 401 amp~ to 600 amps $80.00 2 <br /> <br /> a) Thg fez for branch eircuil~ wi& <br /> <br /> En~:h branoh e~uit ,-~ <br /> <br />b) The fee for brnnch circuits without <br /> pm'a hase of service ce f~ler fee <br />First branch circuit <br />Each additional brmch circuit <br /> <br />B. Miseellaneeus (fi~'vic~ or Feedee Not lneludzd) <br /> Each pump or irrigation circle <br /> Each si~n or outline lighting <br /> SignS. ckcuit~a) or a limited energy <br /> panel, alteration or extension <br />P. Each additional In~don <br /> Over the allowabl~ in say of the <br /> ~0ove, pe~ <br />O. Minc~ In~allation Labels <br /> Pack of 10 labels ~ $5,00 each <br /> (sold ooly to ele~tri~ l co~r~ctors) <br />H. Oth~ <br /> <br /> (As required by l~ildio~ <br /> Aurora Dwelli~ Electrical Fee <br /> Dwelling Permit L~bel <br /> <br />$35.00 <br />$ 2.OO -- <br /> <br />$40.00 2 <br />$40.00 2 <br /> <br />$35.00 <br /> <br />$50.00 -- <br /> <br /> sq, ft. x $.068 = -- <br /># of L~bels <br /> <br />5. FEES Al. Enter total of fees from See. #4 <br /> A2. Add 5% su~harg~ (.05 x Al) <br /> <br />Eabtotal <br /> <br />B. Enter 25% of li~ A1 for P~ Review <br /> (Sec. 3), if required <br />C. Investigation F~e (if requi~l) <br />D. Red.flea Foe ($25.~) <br /> <br /> ~T~ ~O~ D~ <br /> Receipt No. <br /> <br />$ <br />$ <br />$ <br /> <br />$ <br />$ <br />$__ <br /> <br />MC 15-341/96 <br /> <br /> <br />