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Dets:: Salem, Om~lon 97,301phone 58~-~147 <br /> ~ode-A.Phone 4:~0 RM,, - 8;00 A,,M. <br /> <br />ELECTRICAL PERMIT APPLICATION <br /> <br />Owner~,-A ~ .................... Phone;; AddreSS:: ......................... <br />SitusAddm~s:: aL _ ~'~.~V~.~;~.~._ $iteNo,,;; CrGa~Street: <br />..... ~upervi~ing Ele~r~cian, ' .............. ~ Phone:; Addre~:; ....... <br /> <br /> Elemrlcal Oontractor~ No.:: Home Builder~ R~i~tratio~ NO,:: <br /> <br /> El~rioia.% NO :; Building: Alte~atio. U Relocation Change <br /> <br /> Ne. RESIDEN'F]AL <br />__ Residence wiring less than 1000 sq ft ..................... @ $ <br />__ Residence wiring less than 2000 sq. ft .......................................... @ $ 50.00 <br />__ Residencewiringover2OOOsqff ............................................................. @$ 70.00 <br />__ Electricheatinstallationinaxistingmsidence ........ @$ 20,00 <br /> SERVICES <br />__ Temporary Construction Service ................................................................. @ $ 20,00 <br />__ Service change only in an existing residence @ $ 20.00 <br /> Commemlal or Industrial: <br />__ ServicenotOverl00ampemS ................................ @$ 30.00 <br />__ Serviceoverl00ampemsbutnotmomthan200ampems ................................ @ $ 50.00 <br />__ Service over 200 amperes but not mom than 400 amperes @ $ 70,00 <br />__ Serviceover400ampemebutnotmomthan600amperes ............................. @ $ 100.00 <br />__ Serviceover600ampems ............................ @ $ 13000 <br />__ Service over 600 volts .......................................................... @ $ 300.00 <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br /> Installation of Alterations or Relo=ation of Dlattlbutlon Feeders: <br />__ Not momthan 100 amperes .................................................. @ $ 2000 <br />__ OverlO0amperesbutnotmomthan200ampema ....................................... @$ 30.00 <br />__ Over200amperesbutnotmomthan40Oampems .......... @$ 50.00 <br />__ Over400ampems ............................................... @$ 6000 <br />__ Feederover6OOvolts ................................................................................@ $ 80.00 <br /> MISCELLANEOUS <br />__ A, Eechtrailerormobilahomespace(Serviceequipment) @$ 20,00 <br />__ B, Eachsupplyformobilehome(Oonnectton) ................... @$ 2000 <br />~ C, Each irrigation pump (Attach a map showing location) ....................................... @ $ 20.00 <br />__ D, E~ch electric sign or outiice lighting @ $ 20,00 <br />__ E, Each residential swimming pool ............................................................ @ $ 20,00 <br /> BRANCH CIRCUI'FS <br />__ One new cimuit; alteration or extension ...................................................... @ $ 15,,00 <br />__ 'l~vo or more new clmuits; alterations or extensions @ $ 2000 <br />__ Other (as per NEC and Building Official) ...................................................................... <br />__ On-Site Technical Review (apply dJmmly at Marion Courtly only) <br />__ Industrial Plant Inspection (apply directly at Marion Counbj only) .................................... <br />__ Reinspecticn Fee <br /> FEE <br /> <br /> ~ STATE SURCHARGE <br /> Please return COMPLETE APPLICATION // ~-~ ) PLAN REVIEWFEE <br /> with the indicated fee. ~ FLEET SURCHARGE <br /> TOTAL $ <br /> <br />SIGNATURE OF APPLICANT"~e~.~ '~~~ ' " <br /> HOMEOWNER'-I h~~C~ ,~ti~ I propose to make an eJe~dceJ in~.llatio, for <br /> <br />S~GNATURE OF APPLI~NT, <br /> <br /> <br />