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Ret. elveS By ..... <br />Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br />ELECTRICAL PERMIT APPLICATION <br /> <br />Job Address: <br />bloctdcal Firm: <br /> <br />Electrical Contractor's No.: / <br /> <br />Supervising Useof <br />[- le,.:kicia n's NO.~:~ ~./..~ '~ Building: <br /> <br />Mailin9 Address: <br /> <br /> Site No.: Cross Street: <br /> Phone: Address; <br /> Phone; AddFess: <br /> <br />HPr~ E~t~Jl~J~;~ I~istration NO.; <br /> <br />nesidential EJ LJ .......... ,~'d-d~ {i~ ~ ' '-~ ...... ~ccupancy <br />Commercial ~ Alteration ~q Relocation [7 Change <br /> <br /> No. RESIDENTIAL <br /> Residence wiring less than 1000 sq. ft ....................... /S $ <br />........ Residencewidnglessthan2000sg [t .............................. ii $ <br /> ....... Resldenoe wiring Over 2.000 sq, ft ................................. ¢~ $ <br /> Electric heat installation in existing residence ........................ ('n $ <br /> SERVICES <br /> Temporary Construction Service ................................... (!~ $ <br />...... Service change onty in an existing residence .................... (¢¢ $ <br /> Commercial or Industrial: <br />........ Service not over 100 amperes ............................... (e $ <br /> Service over 100 amperes but not more than 200 amperes ............... (i~ $ <br />....... Service over g00 amperes but not more than 400 amperes ................ (~i $ <br /> Service over 400 amperes but not more than 600 amperes ................. Ce $ <br />........... Service over 600 amperes ......................................... th: $ <br />......... Service over 6,00 voits ........................................... ('(,$ 450.00 <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br /> Installation of Alteratlon~ or Relocatio~ of Distribution Feeders: <br />.............. NOtmorethanl00amperes ......... ,,~ ......................... a! $ 25.00 <br /> Over 100 amperes but not morethan 200 a~"pSrea ..... ,' ............. e , (ii $ 40,00 <br /> Over 200 amperes but net more than 400 amperes .................. fh,$ 70.00 <br />.......... Over 400 amperes ....................................... (~ $ 85.00 <br /> Feederover600volts ....................................... (S $ t20.00 <br /> MISCELLANEOUS <br />............ A. Each trailer or mobile home space (Service equipment) ................. g/ $ 25.00 <br /> B. Each supply lot mobile borne (Connection) ...................... f~ $ 25.00 <br />.......... C. ~ael~irrigationpump(Attachamapshowinglocation) .................... el $ 30,00 <br />......... B, Each electric sign or outline lighting .............................. (s, $ 3000 <br /> E Each swimming pop/bOnding) ............................... fi~ $ 3000 <br /> BRANCH CIRCUITS <br />........ One new circuit; alteration or extension ...................... (h S 20.00 <br />__/ Twoormorenewcircuits:alterationeorextension5 ................. /e S 30.00 <br /> Other (as per NEC and ¢.~ilding Official) <br />......... On-Site Tecbnlcal Review (apply directly at Marion .County only) ............... <br /> <br />50,00 ........ <br />75.00 <br />105,00 <br />30.00 <br /> <br /> 30,00 <br /> 30,00 <br /> <br />45,00 <br />70,00 <br />100.00 <br />150.00 <br />200,00 <br /> <br /> .......... Industrial Plant Inspection (apply directly at Marion Oo=nty only) ................. ,_ .................... <br /> Reinspection Fee ........................................ fi~ S 20.00 <br /> F E E .... ;;' ;".;;. <br /> STATE SURCHARGE <br /> Please return COMPLETE APPLICATION PLAN REVIEW FEE <br /> with the indicated fee, iNVESTIGATION FEE <br /> FLEET SURCBARG6 <br /> TOTAL _$_' <br /> <br /> ~Sr m.~ II) m~lkc Ibc electrical inmallation a¢oorSing to the Submitted plans and ~pedficatJ~n$, me 18w$ Ot me $t~le el e~egon 8ns the O~dinar~ces el Marion County. <br /> <br /> HOMEOWNERS - I horeby certify that I ar'n the owner Of the property described a~hict~ location I prOpoSe lo make 8n electrical installation fer <br /> my own use a~d this property i~ not being constructed for sale, lease or rent <br /> <br />".~fGNATURE OF APe[ ]CANT <br /> <br /> <br />