Laserfiche WebLink
FOR CITY VALIDATION <br />Received by:. <br />Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br />COMMUNITY DEVELOPMENT CENTER <br /> 285 Church St NE · Room 132 PERMIT NO: <br /> Salem, OR 97301 <br /> <br /> Date: <br />24 hr. Inspection Line 373=4427 <br />Office: Phone $88-5147 8:00am - 4:30pm <br />PAX: $8S-794S lasuecl by: <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete all Sections, I through 5 <br /> <br />1. LOCATION OF INffrALLATION <br /> <br />PERIVflTS ARE NON-TRANSFERABLE AND EXPIRE IF WORK IS NOT <br /> I <br /> STARTED ~ 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPI~qDED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br />Ele~tfiealC°ntraet°r~::~'/tC% ~-~1 ~n~ <br /> <br />Property Ovn~r r Phone <br /> <br />Coatraetor'.ri~selqo. '~ ~//-,.3/0 C., <br />ConWaclor's Board Reg. No. ~.,~/~ I,ob o. <br /> <br /> FOR OW~ INSTALLATIONS <br />Property Owner (p/~pritU) <br /> <br />Mailing Address I Phone <br /> <br />Ci~y/~me/Zip <br /> <br />Owner's Signature: <br /> <br />3. PLANRBVIHW 8BCTION <br /> <br />Marion County does not require a plan review. <br />We will provide plan review service if you complete <br />Section 5B and submit two (2) sets of plans and <br />specifications with this application. <br /> <br />4. 1~]~ ~CHI~DUL]~ (Completu and ~tar total in A1 below) <br /> Nmnber of lnapeetions po' permit allow~i ..~ <br />A. <br /> Rezidentinl <br /> Unit <br /> Service Ineinded: Items Co~t (eneh) Sum <br /> 1000 sq. ft. or less $85.00 4 <br />Each additional 500 sq. ft. <br /> or porlion thereof $15.00 -- <br />limited Energy $20.00 __I <br />Each Manufactured Home or Modular <br /> Dwelling Service or Feeder [ $40.00 2 <br /> <br />B. g~vinea or Feed~ ~ (Does not include branch circuits, se~ section D) <br /> <br />200 mnl~ or less $50.00 <br />201 ~nps to 400 amps $60.00 -- <br />401 amps to 600 amps $100.00 <br />601 amps to 1000 amps $130.00 <br />Over 1000 amps or volts $300.00 <br />Reconnect only $40.00 -- <br /> <br />Temporary Set vioea, Feede~s <br />InBtallatinn, Alt~ation, ~ Relocation <br />200 amps or less $35.00 -- <br />201 amps to 400 amps $40.00 -- <br />401 amps to 600 amps $80.00 <br />Over 600 amps or 1000 volts <br /> <br />Branch Cir~uitu <br />New, AIte~atinn~, or Ealen~ion Pe~ Panel <br />a) The fee for branch circuits with <br />purchase of service of feeder fee <br />Each branch circuit $ 2.00 -- <br /> <br />$ 2.00 <br /> <br />E. Miscellaneous (8~rvie~ ~' Feede~ N~ Include) <br />~ch pump or i~igation ci~l~ $~.~ __ <br />~ch si~ or outline li~ting $~.~ ~ <br />Si~al e~t(s) ora l~i~d en~ <br /> <br /> Over ~e allowable ~ any of ~e <br /> a~ve, ~r ~peet~n $35.~ ~ <br /> <br />Pack of 10 labo~ ~ $5,~ each $~.~ ~ <br />(~d only to electrical co~rsctors) <br />H. 0~ <br />(~ required by ~il~ O~cial) <br />Aurora Dwelling El~cal F~ <br /> <br /> sq. fl. x $. 068 = <br /># of L~bola <br /> <br />2 <br />2 <br />2 <br />2 <br />2 <br />2 <br /> <br />2 <br />2 <br />2 <br /> <br />2 <br />2 <br /> <br />2 <br /> <br />5. FEES <br />Al. Enter total of fees from Sec. #4 $.__ <br />A2. Add 555 surcharge (.05 x Al) $.__ <br /> gubtotal $ <br /> <br /> B, Enter 25% of line Al for plan Review <br /> (Sec. 3), if required <br /> C, Investigation Fee (if required) $.__ <br /> D. Reimpection Fee ($25.00) $.__ <br /> <br /> TOTAL AMOUNT DUE $.__ <br /> Receipt No. <br /> <br />MC 15-341/96 <br /> <br /> <br />