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MARION COUNTY BUILDING INSPECTION <br /> ,,¢/, /-: i~::'"~ S ....... '~g, No.:~ ~ <br />t~ece~ved Sy; <br /> <br />Date: <br /> <br /> ~~'~3[~ C(', j~'~ ELECTR CAL PERMIT APPLICATION <br /> Phone: Address: <br /> <br />S.t~ervising Electriciao: / <br /> <br />Phone; <br /> <br />Phone: <br /> <br />Supervising -'~ C"[~;¢'- . Useof Residential ~ New ~ Addition [] OccupAncy <br />Electrician~ NO..'~'J T~_,2 Building: Commercial Alteration ~ Relocation [~ Change <br /> <br /> No, RESIDENTIAL <br /> __ Residence wiring less than 1000sq. ft ................................. C~ $ 50,00 <br /> .... Residence wlrlng less than 2000 ag. ft ................................. RS 75,00 <br /> __ Residence wiring over C'000 sq. ft .................................... Cq~$ 105,00 <br /> ...... Elemric heat installation in existing re¢idence ........................... ~ $ 30,00 <br /> SERVICES <br /> Temp0ra~y Construction SeYvioe ..................................... C~ $ 30.00 <br /> Servicechangeonly in an existing residence ........................... @ $ 30,00 , <br /> Commercial or Industrial: <br /> .... Service not over 100 amperes ....................................... Cq~ $ 45,oo <br /> __ S~tvk~e over tog Amperes but not more than SOO Amperes ................. (¢ $ 7(},0d <br /> __, Servicoover200amperesbutnotmorethan400amperas ................. ('~$ 100,00 <br /> Service over 400 amperes but not more than 600 amperes ................. ~ $ 150,00 <br /> __ Serviceover600amperes ......................................... {¢~$ 200.00 <br /> __ Serviceover600voRs ............................................. ~. $ 450 00 <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br /> lestellation of Alterations or Relocation of DiStribution Feeders: <br /> ..... Not more than 100amperes ........................................ @ $ 25,00 <br /> __ Over l00 amperes but cot more than 200 amperes ....................... (~$ 40.00 __ <br /> __ Over200amperesbutnotmorethae400amperes ....................... @$ 70,00 <br /> ....... Over 400 amperes ............................................... {~$ 85.00 <br /> __ Feederover600volts ............................................. ~)$ 120,00 <br /> MISCELLANEOUS <br /> __ A. EACh trailer or mobile home space (Servlceequipment) .................. @ $ 25,00 <br /> __. B. Each supplyfOr mobile home(Connection) ........................... (~¥' $ 25.00 __ <br /> ___ C, ~:achirrigationpump(AttachamapshowlngloeaSon) ..................... ~e$ 30.00 <br /> D. Each electric sign or outline lighting ................................ ~,~ $ 30.00 __ <br /> __ E, Each swimming pool (bondlng) ................................... C¢ $ 30,00 <br /> SRANCH CIRCUITS <br /> .... One new circuit; alteration or extension ............................... ~' $ g0.00 <br /> .__ Two or more new circuits; alterations or extensions ....................... @ $ S0.00 <br /> __ Other (as per NEC and Buildlng Official) ......................................... <br /> On-Site Technical Review (apply directly at Marion County only) ...................... <br /> __ Industrial Plant In,spection (Apply direogy at Marion County only) ...................... <br /> __ Reinspection Fee ................................................ ¢i~ $ 20.00 <br /> <br /> STATE SURCHARGE ,, <br /> Please return COMPLETE APPLICATION PLAN REVIEW FEE <br /> "" th in-i -. NVEST GATION FEE . <br /> wt~n e acate?_ee....~..,...~_..j~.p_..;~E.~L ~DU..£ .)'~ FLEETSUIACHARGE ~'/,'~'~ <br />~'"~1-'~1-'}~ ,~'~g'll''~'~"''t~'~'t'''T~j~l'~' TOTAL $ ~ 2L. ~- <br /> <br /> No: <br />SIGNATURE OF APPLICAN~ ~ . ,.~,~t~ _~' J/~u~.~'/4~-~r ,,, <br /> . (Su¢(~rv[sing Electrician) <br /> HOMEOWNERS - I hereby certify that I am the owner of the property described above, at which location I propose to make an electrical installation for <br /> my own use ~nd this property is not being constructed for sale, lease or rent, <br /> <br />SJGNA'I'URE OF A~I~LICANT: <br /> <br /> <br />