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MARION COUNTY BUILDING INSPECTION ~/7'~,~_[/T~, <br /> COMMUNITY DEVELOPMENT CENTER [~ <br /> 85 Church St NE - Room 132 . <br /> FOR CITY VALIDATION~Ke~IV[i f 97301 PERMff NO. <br /> mr ~.~-~"~' -- Salem, OR <br />I Received by [~** ~ <br /> Date: <br /> I-,~ t~ :' ~,~1~ 24 hr. Inspection Line 373-4427 <br /> Issued <br /> by: <br /> <br />ELEC'rRICAL PERMIT ~.~NB <br />Please comp/pro ~18ec~l~'~" l'~hrough $ [ <br /> <br />1. LOCATION OF INSTALLATION <br /> <br /> PERMITS ARE NON-TRANSFERABLE AND EXPIRE IF WORK IS NOT <br /> STARTle) WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPI~DED FOR 180 DAYS. <br /> <br />2A. COHTRACTOR INSTALLATION ONLY <br /> <br />FOR OWNER INSTALLATIONS <br /> <br />Properly Owner ~/~ print) <br /> <br /> Ci~y/StateZZip <br /> <br /> Owner's Signature: <br /> <br />3. PLAN REVIBW 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-$41/96 <br /> <br />4. FEE SCHEDULE (Complete and enter totalln Al below) <br /> Nmnbe~ of Inspections p~r permit allowed <br /> Re~idmtial <br /> Per <br /> Unit <br /> <br />1000 sq. ft. or Icsa $85.00 <br />Each additional 500 scl. ft. <br /> or po~on thereof $15.00 ~ <br />I~mitod Energy ~ $20.00 ~ <br />Each Manufaetor~d Home or Modular <br /> Dwelling Service or Feeder $40.00 <br /> <br /> Installation, Alteration ~ Relocation <br /> 200 aml~ or le~ $50.00 2 <br /> 201 nmp~ to 400 amps $60.00 -- 2 <br /> 401 ampsto600 amps $100.00 __2 <br /> 601 amps to 1000 amps $130.00 <br /> Over 1000 amps or volta $300.00 2 <br /> Reconnect only $40.00 2 <br /> <br />C. Temporary <br />Intsallntion. Alteration, ct Reloe~tlon <br />200 amps or less $35.00 -- <br />201 amps to400 am[~ $40.00 <br />401 amps to 000 arnp~ $80.00 2 <br />Over 600 amps or 1000 volts <br />see ~S* above <br />D. Br~nch Cireuita <br /> <br /> Each sign or outline lighting $40.00 2 <br /> Pack of l0 labels ~ $5.00 each $50.00 -- <br /> <br />5. FEES Al. Enter total of fees from Sec. <br /> A2. Add 555 sureharg~ (.05 x Al) <br /> <br />~ubtotal <br /> <br />B. Enter 25% of linc A 1 for plan Rcvlew <br /> (Sec. 3), if required <br />C. Investigation Fee (if required) <br />D. Reinspection Fee ($25.00) <br /> <br /> TOTAL AMOUNT DUE <br /> Receipt No. <br /> <br /> <br />