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~ro'b Address: it C~SS Street: ......... <br /> , ............. <br /> Electrical Firm: Phone: Addms~: <br /> <br /> E]~'~r~r~ NO: ....... Home Builder~ Registration No.: <br /> ~upervislng .......... ~' U'se of Resldenfi~l ~ New ~ ....... Addition ~ Occupancy ..... <br /> <br />....~leo~rioi~n~ No~ ~ ......... / ~ Buildi~g~~ Commercial '~ Alteration ~ Reloo~tlon ~ Change D <br /> <br /> NO. RESIDENTIAL <br /> Residence wiring leas than 1000 sq, ft ................................. @. $ 50,00 <br />___ Residence wiring lees than 2000 sq, ft ................................. @ $ 75;,00 __ <br />__ Resldencewidngover2000sq. tt .................................... @$ 105.00 <br />.... Electric heat installation in exiating residence ........................... @ $ 50,00 <br /> SERVICES <br />__ TemporaryConatruction Service ..................................... ~2~ $ 30,00 <br />__ Service change onlyin an e×JeUng realdeace ........................... @ $ 30.00 <br /> Commercial or Industrial: <br />__ Service notover 100 amperes ....................................... @ $ 4&00 <br />__ Service over 100 amperea but not more than 200 amperes ................. @ $ 70,00 <br />.... Service over 200 amperes but not more than 400 amperes ................. ~ $ 100,00 <br />Servi~e over 400 amperes but not more than 600 amperes ................. ~; $ 150,00 <br />__ Service ever 600 amperes ......................................... @ $ 200.00 <br />__ Serviceovere00voJts ............................................. @ $ 450,00 __ <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br /> Installation of Alterations or Relocation of Distribution Feeders: <br /> Not more than 100 amperes ........................................ ~.z?$ 25.00 <br />__ Over 100 amperes but net more than 200 amperea ....................... ('i~ $ 40,00 <br />...... Over 200 amperes but not more than 400 amperes ....................... ~t$ 70.00 <br />__ Over400amperes ............................................... @$ 85,00 <br />....... Feederover 600volts ............................................. @ $ 120.00 <br /> MISCELLANEOUS <br />__ A, Each trailer or mobile home space (Service equipment) .................. ~D $ 25,00 <br />...... B. Each supply for mobile home (Connection) ........................... ~ $ 25.00 __ <br />__ O, Each irrigation pump (Attach a map si~owir~g location) ..................... ((t $ 30,00 <br />~ D, Each electric sign or outlinelighting ................................ (~ $ 30.00 <br />,/ E. Eachswimming pool(bonding) ................................... (i~~ $ 30,00 <br /> BRANCH CIRCUITS <br />........ One new clrcult;alter~tion or extension ............................... @ $ 20,00 __ <br />.__ Tweermerenewcircuits;aJterationeorextenaions ....................... @$ 30,00 <br />__ Other (aa per NEC and BuiJdlng Officlal) ......................................... <br />On-Site Technical Review (apply directly at Marion County only) ...................... <br />___ ]ndusIrial Plant Inspection (apply dlrectly at Marion County only) ...................... <br />___ Reinspection Fee ................................................ @ $ 20.00 <br /> FEE <br /> STATE SURCHARGE <br />Please return COMPLETE APPLICATION PLAN REVIEW FEE __ <br />with the indicated fee. INVESTIGATION FEE <br /> FLEET SURCHARGE <br /> TOTAL <br /> <br />[] HOMEOWNERS- I hereby ce~y that I am the owner of the prcperty de~crib~U~b~:g, ~¢~li~r~ IDeation ] prepose to make an electrical Instal-- ' i~tion--for <br /> my own use and this property ia not being constructed for aale, lease o{ rent. <br /> <br />SIGNATURE OF APPUCANT;.__ <br /> <br /> <br />