Laserfiche WebLink
FOR CITY USE ONLY <br />~ecei~ By:, · Date: <br />Zoning By: City: <br />~ece~pt # Amount: <br /> <br />I ELECTRICAL PERMIT APPLICATION <br /> Please complete all Sections, I through $ <br /> <br />1. LOCATION OF INSTALLATION <br /> <br /> P~o~:~ .~///~ , <br /> <br /> P~ject ~fiption: ~ S~ ~ <br /> <br />PERM~ ~E NON-T~NSFE~ AND EXPIRE IF WOR~ <br />IS NOT STATED WITHIN 180 DAY~ OF ISSUANCE OR IF <br />WORK IS SUSPE~ED FOR 18~ DA~ <br /> <br /> CONTRACTOR INFORMATION <br /> <br />M~lmg A~ess:~ <br />City: ~~ S~te: ~ <br /> <br />2B. FOR OW2~ER INSTALLATION <br /> <br /> Property Owner: (please prinO <br /> <br /> Mailing Address: <br /> <br /> City: State: Zip: <br /> <br />I am the PROPERTY OWNER and own, reside in, or will reside in <br />the coml~eted structure and will be my own general contractor. 1 <br />understand that I must register as a construction contractor if the <br />structure is soM or offered for ~ before or upon completio~ If I <br />hire subcontractors, I will hire only subcontractors registered with <br />the Construction Contractors Board. If I change my mind and do <br />hire a general contractor who is registered with the Construction <br />Contractors Board, 1will immediately notify Maton County of the <br />name of the contn~ctor. <br /> <br />Owner's Signature: <br /> <br />3. PLAN REVIEW SECTION <br /> <br /> Marion County does not require a plan review. We will provide plan <br /> review service if you complete Section 5B and submit two (2) sets of <br /> plans and spec f~cat OhS w th this applicat on. <br /> <br />MC 15-34 Rev 9/98 <br /> <br /> MARION COUNTY BUILDING INSPECTION <br /> 3150 Lancaster Dr. NE - Suite C <br />Salem, Oregon 97305 <br />8:00am - 4:30pm 24 HR Inspection Line 373-4427 FAX 588-7948 <br /> <br /> Number of inspections p~ permit allowed <br />A~ Re~ld~0al Per Unit Servl~ Inclmind: <br /> <br />__ x <br /> <br />B. Services or Feeders (Does not include branc~ Cir..nils, s~ secthm D) <br /> Iastalint~n, Alteration o~- Rdecatto~ <br /> 200 amps or less <br /> 20l arr~ to 4OO amps <br /> 401 araps to 600 amps <br /> 601 un, to lO00 amps <br /> Over 1000 amps or volts <br /> Rec~nect Only <br /> <br /> One/P, voFm~yDwelUngFee:Sq.F~ __ x $ .09,~$ <br /> <br />Al. Enter total of fees from Sec. 84 <br />A2. Add State Surcharge (.05% x A1 <br /> <br />SUBTOTAL <br /> <br />B. Eater 30% of line A1 for Plan Review <br />C. Investigation Fee (if required) <br />D. Reinspection Fee ($50.00) <br />E. Additional Plan Review ($62.50/hr, <br /> minimum one-half hour) <br />E lasgection for which no fee is specifically indicatmt, <br /> ($62.50thr, minimum one hour) <br />G. Inspection Outside Normal Business Hours, <br /> ($62.50thr, minimum two hours) <br />H. Industrial Plant ($62,50/br) <br /> <br />TOTAL AMOUNT DUE <br /> <br /> <br />