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n 'g.4ZI V IZI.;. i ....... ~' ........................... ,~ MARION COUNTY BUILDING INSPECT ON · OR cn'v use ONLY .IIIN 9 ~q lqgq ~] 315o L~.a3~0 La. cas~r Dr. ~E- S~ C R~i~ By:. Da~: ......... ~ S~m, Oregon 97305 ~ By: Ci¥ 4 ~=.~. ~.at. = MARION COUN~-:30pm :4 ~. m~ion Line 373~427 F~ 588-7948 ....... ] ................. ]] ........ ~ILDING INSPECTION ELECTRICAL PERMIT APPLICATION Please complete all $eclions, I through $ ~oj~ ~rlpti~: 4-//7~ ,, PERMT~S ARE NON-TRANSFEP~BLE/~ND EXPIR~ IF WORK IS NOT ST~I~D WI~tlN 150 DAYS OF ISSU~iVCE OR IF WORK IS S~]SP£NDED FOR 1~0 D/IY~ CONTRACTOR INFORMATION Parkin Electric, Inc. 20250 S Mctalla Ave. Oregon City, OR 97045 503-657-4958 fax: 557-~059 Contractors License #: 34-4C exp. ~0-01-99 Supervisor: 424~-8 exp. 10-01-01 Conlraolor$ Board Reg #: 35151 exp. 10-12-00 Metro # 2416 exp 11-01-99 Owner: Supervisor Lk~n~ Signature of Supervising Electrician: 2B, FOR OWNER INSTALLATION PrO~aly Ov~: (please print) Mailing Address: City:_ State: Zip: I am the PROPER TY OWN£B and own, reside in. or will reside in the compteted structure and wil! he my ow~ geeteral ¢ontractoL understand thai ! must regisrer ~$a co~tr~clio~ co~tr~cto~ ~ the s~uc~ure ~ ~old or o~ered for ~ale before or hire subcon~octars, t wilt hire only ~ubcontractor~ reentered with the Cons~uction Con~actor~ Board. Ill change my mind and do hire a general con.actor who i$ registered with the Construction Con.actors Board. I w~H immediately not~ Marion Coun¢ of the name of the contractor: 3. plAN REVIEWSECTION Mar/on County dens not require a plan review. We will provide plan review ~.'v i ce if yon complete Section 5B and submit two (2) 4. FEE SCIIEDULE {complete and enter total ia All Numb~ of Inapections p~ p~mit allowed-- A. Residential Per Unit, Service Included Items Co~ (~ac~) Sum 1000 St. Ft. or less x $110.00 Modular Dwelling Service or Feeder / x $ 52.00 200 amps or less -- x $65.00 20l amps to 400 am~ -- x $80.00 40l ampsto 600 amps x $130.00= $ 2 601 amps to 1000 amps x $170,00 = $ 2 Ov~ 1000 amps or volls -- x $390.00 = $ 2 Rec, onnemOnly -- x $ 55.00= $ 2 C~ Temporary S~rvieesIFeeders l~atalL~tioa,3,1t~r~tio~, o~' Kt~af~a 200 amps or less x $ 45.00 ~ $ 2 201 amps to 400 amps x $55.00 ~ 401 araps to 600 amps x $110.00~ $ . O~e~ 60~ amps ot 10~0 vol~, see "B" above D. Brauch CircnRs New, Alteration, or Extension Per Panel a) thc foe for branch circuits w~bh t~e purchase ogServiccorPeedcrFce. EaBrCir x $ ~.00 = $__ ) The fe~ for branch ckcuits without the nurchas~ of Service or Fe~cler Fee: First Branch Circuit x $ 50.00 = $ EachAddifionalBotnchCkcuit x $ 3.00 -- ~iscelta~eoas (S~rviee or Feeder Not Included) n pump or fixigadon circle X $ 55,00 = $ 2 h Sign or Outline Lighting x $ 5~.00 = $ 2 Iai Circuit(s) or a LimJtod Energy Panel, ~dteration. or Exlemion x $ 55.00 = $ over the allowable in any or the above, per inspection x $ 50.00 = G. Minor Installation Labeb Pack of i0 labels (~ $10.00 each x (Sold only to Elvelfieal Cormactom) IL Industrial Plant x $62.50 / ht ~ $ One/Tv,~FamilyDwelli~g F¢e:Sq. Fe¢t x $ .09 =$ Dwelling Permit Labels (For Single Family Dvntllings Only) ~/~ OTIIER, as required by the Building Official TOTAL 5. FEES Al. EnterTo~ Fees from Section #4 A2 Add State Surcharge (.05% x Al) SUBTOTAL: $ ~'~/< ~ B. Enter 30% of line Al for Plan Review C. Investigation Fee, if required D. Relnspection Fee ($50.00) E. Additional Plan Review (62.50/hr, minimum one-half hour) F. Inspection for which no fee is specifically indicated, ($62.50/hr, minimum one hour) G. h~spcction Outside Normal Business Hours, $62.50/hr, minimum t~o bouts) FI. Indusa'ial Pl~t ($6ZSO/hoLlr) TOTAL AMOUNT DUE MC 15-34 Rev 9/98