ELEC - 1593785 - Laserfiche WebLink

Home Browse Search

FOR CITY USE ONLY Received By: .Da~e: Zoning By: City: Receipt#: Amount: $ ~ ELECTRICAL PERMIT APPLICATION I Please cornplete all Sections, 1 through 5 I 1. LOCATION OF INSTALLATION Parcel ID: Zip: Proj~:t Description: PEP~IITS ARE NON-TRANSFERABLE AND EXPIRE IF WORK I IS NOT STARTED WiTHIN 180 DAYS OF ISSUANCE OR IF WORK 15 sUSPENDED FOR 180 DAYS. 2A. CONTRACTOR INFORMATION 2B. FOR OWNER INSTALLATION Property Owner: (ptec~e print) Mailing Address: City: State: Zip: I am the PROPERTYOWNER and own, reside in, or wilt reside in the ~ompl~ted structure and will be my own general contractor. I understand'that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion, lf l hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change my mind and do hire a general contractor who is registered with the Construction Contractors Boarc~ I will immediately noti~ Marion County of the name of the contractor. owner's Signature: 3. PLAN REVIEW SECTION Marion County does not require a plan review. We will provide plan review setwice if you complete Section 5B and submit two (2) sets of p aris and specificat ohs with th s app cation. MC 15-34 Rev 9/98 MARION COUNTY BUILDING INSPECTION 3150 Lancaster Dr. NE - Suite C Salem. Oregon 97305 8:00am - 4:30pm 24 HR Inspection Line 373-4427 FAX 588-7948 4. FEE scHEDuLE (eemplete and enter total in Al) Number of InspeCtiOns p~' peri. it allowed A. Resldeetlai Per Unit Sersiee lncldded: Items Cost (o~h) Stun 1000 sq. /t. o~ less -- x $1!0.00=$ 4 E~h additional 500 sq. fl. or poalon thereof -- x' $20.00: $ -- Limi~iEner~' -- x $30.00=$__1 ~h Manufactu~d Hom~ or Modular Dwelling Se~ic~ or Fc~t~r x $52.00 = B. Services or F~lers (Do~ n~t thclude bnmch Circuits, 200 amps or less 201 amps to 400 amps 401 amps to 600 ~tmps 601 amps to 1000 amps Over 1000 amps or volts R~eon~:t Only C. Temporary Services/pedders Ins~lluiion~ AltaratioJ~ or Relaeotlan 200 amps or less 201 amps to 400 amps 401 amps to 600 amps Over 600 amps or i000 volts see "B" abeV¢ D. Branch ~ts New, Alteration, or Extension Per Penal a) The fcc for branch circuits with the ourchaze of Se]~ice or Feeder Fee: Each branch circuit ~ x $3.00 = $ b) The fcc for branch circuits without the nurchase of Se~iee or Feeder Fee: F~st branch circuit __ x $50~00 = $ -- Each additional branch circuit -- x $3.00 = $ F~ Miscellaneous (Service or Feeder Not Included) Each pump or irrigation circle -- x $5~.00 = $ 2 Each Sign or Outline Lighting -- x $5f00 = $ 2 Signal Chcuit(~) or a Limited Panel, Altermion or Exr~flsi~ __ x $5~.00 = $ 2 F. Each additional Inspection over the allowable in any of the above, per thspoctfen -- x $50.00 = $ G. Minor Installation Labels Pack of 10 labels @$10.00 each -- x $1~0.00 = $ (Sold only to Electrical Contractors) H. Industrial Plant __ x $62.50thr = $ -- OneflX~ Fmuily Dwe]lhg Fee: Sq. Fc~t x $ .09 = $~ Dwelling Permit Labels (For Single Family Dwellings Only) N/C OTHER, as required by the Building O~adui $ -- TOTAL $ $65.00 =$ 2 $80.00 = $ 2 $130.00 = $ 2 S170.00 = $ 2 $390.00=$__2 $55.00 = $ 2 __ x $4f60=$__ -- x $55.00=$__2 -- x $110.00=$ 2 5. FEES Al. Enter total of fees from Sec./~4 A2. Add State Surcharge (.05% x Al) B. Enter 30% of line A1 fur Plan Review SUBTOTAL C. Investigation Fee (if required) D. Ralaspection Fee ($50.00) E. Additional Plan Review ($62.50/hr, minimum one-half hour) E Inspection fur which no fee is specifically indicated, ($62.50/hr, minimum one hour) G. Inspection Outside Normal Business Hours, ($62.50/hr, minimum two hours) H. Industrial Plant ($62.50/hr) TOTAL AMOUNT DUE