Laserfiche WebLink
~lrOR CITY USE ONLY <br />Received By: .Date: <br />Zoning By: City: <br />Rcculpt #: Amount: $ ;, <br /> <br />[ELEC~CAL PE~ APPLICA~ON <br /> <br /> rr~lrS a~ ~oN.r~sr~ ~o z~r ir wos~ [ <br /> <br /> ~ CO~R ~FO~ON <br /> <br /> zip:f93 <br /> <br />Supervisor License No.: <br /> <br /> / <br />2B. FOR OWNER INSTALLATION <br /> <br /> P~operty Owner:. (p/ease print) <br /> Mai~g Add. ss: <br /> City: State: Zip: <br /> <br />I am the PROPERTY OWNER and own, reside in, orwill reside in <br />the completed structure and will be my own general contractor. I <br />understand that I must register a~ a construction contractor if the <br />structure is sold or offered for sale hefore or upon completiot~ lf l <br />hire subcontractors, I will hire only sttbcontractors registered with <br />the Construction Contractors Board. If l change my mind and do <br />hire a general contractor who is registered with the Construction <br />Contractors Board, I will immediately noti~ Marion County of the <br />name of the contractor. <br /> <br />Owner's Signature: <br /> <br />~. PLAN REVIEW SECTION <br /> <br /> Marion County does nat require a plan review. We will provide plan <br /> ~eview aervice if you complete Secti°n 5B and submit two (2) set~ of <br /> plans and specifications with this application, , <br /> <br /> MARION COUN'rY BUILDING INSPECTION <br /> 3150 Lancaster Dr. NE - Suite C <br /> Salem, O~gon 97305 <br />8:00am - 4:30pm 24 HR Inspection Line 373-4427 FAX 588-7948 <br /> <br /> Num~r of lml~ctiom lin' I:emait allovmd <br /> <br /> . ~ ~ Items Cost (~c,h) Stun <br /> 1000sq. ft. orless __ x $110.00=$ 4 <br /> Each additibnal SOO sq. ft. orpo~tionthexeof -- x $20,00-=$__ <br /> Limitexl Energy x $30.00 = $ -- I <br /> Each Manqfaetur~l Home or <br /> Modular Dwelling Sexvi~ or F.~d~ x $52.00 = $ 2 <br /> B. Sorvk~ or F~-d~rs (Do~ not ~ brm~.h ~ ~ s~ti~n D) <br /> <br /> 201 amps to 400 amps __ x $80.00 = $ 2 <br /> <br /> Over 1000 amps or vo~ x $390.00 = $ -- 2 <br /> $35.00 = $ <br /> <br /> ln~afilafion, Alterations, 0r Rdocafion <br /> 200ampaorless · x $45.00=$ : 2 <br /> 201 amps to 400 amps -- x $55.00 = $ 2 <br /> 40~ amps to 600 amps x $110.00 :~$ 2 <br /> D. Bmanh Ci~uit~ <br /> New, Alteration, or l~l~on Per Panel <br /> a) The fee for branch c~uas with the <br /> <br /> Eachbranchci~uit ·.-- x $3.00--$__ <br /> b) The fee for branch circuits V, lthout the <br /> <br /> F~t branch circuit -- x $50.00 m $ <br /> Each additional branch circuit -- x $3.00 = $ -- <br /> ~ Ml:a~.B~m~m (Serv~ or F~l~r No~ l~clml~) <br /> Each pmap or i~igation circle -- x $35~00 = $ 2 <br /> <br /> Each$ignorOutlin~Ligtaing -- x $55.00=$ <br /> Si$oat Circuit(s) or a Limi~l <br /> <br />F. Each additional Inspection <br /> <br />above, per inspection -- x $50.00 = $ <br />G. Minor Installation Libels <br /> <br /> (Sold only to Electrical Contractors) <br /> <br /> One/Fwo Family D~ F~: Sq. Feet <br /> <br /> -- x $I00.00=$ <br /> <br /> -- x $62.50/br = $__ <br /> <br />Dwdllng Permit Labels (For Single Family Dwellln~ Only) <br /> <br />O~ a~ rl~lUll~d by the Building ~ <br /> <br />Al. Enter Wmi of fees from Scc. g4 <br />A2. Add state Surcharge (.05% x Al) <br /> <br />SUBTOTAL <br /> <br />B. Enter 30% of ~in¢ A1 for Plan Review <br />C. Investigation Fee (if required) <br />D. Reiaspection Fee ($50.00) <br />E~ Additional Plan Review ($62.50/hr, <br /> minimum one-half hour) <br />F. hsp~ction for which no fan is specifically indianted. <br /> ($62.50/hr, mluimum one b. our) <br />G. Inspection Outside Normal Business Hours, <br /> ($62.50/hr, minimum two hours) <br />H. Industrial Plant ($62.50/hr) <br /> <br />TOTAL AMOUNT DUE <br /> <br />$ <br />$__ <br />$__ <br /> <br />$ <br /> <br />$ <br /> <br />MC 15-34 Rev 9/98 <br /> <br /> <br />