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Received By; <br /> <br />Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> ~enster Bldg. No. 225 <br /> 220 High Street NE <br /> Salem, Oregon 97301 <br /> <br /> Phone ~8-5147 <br /> Code-A-Phone 4:30 P.M, - 8;00 A.M, <br /> <br />ELECTRICAL PERMIT APPLICATION <br /> <br />"~'w'n'~rl ...... Phone: Address: <br />Situs Address: __ ~ / Site No,: Cms~ Street: <br />Elec~rica~ Fi~ ~ , T, Phone: Address: <br />S~per~' in Ele~ricia: Phone: ~dre~: <br /> <br /> EIo~rical Co~tract0r~ No: Home Builder's Registration No.: <br /> <br /> Supervising Useof New ~ Addition ~ Occupancy <br /> Electrician'sNo.: ~?~ Building: ~ Alteration~ Reloceti0~ ~ Cha~ge <br /> <br /> No. RESIDENTIAL <br /> Residence wiring less than 1000 Sq, ff ................................. ~ $ 30.00 <br /> / Residence wiring less than 2000 sq. ft. ,. @$ 50.00 <br /> Residence wiring over 2000 sq. ff .................................... @$ 70.00 <br /> Electric heat installation in existing residence ........................... @ $ 20.00 <br /> SERVICES <br /> Temporary Construction Service ..................................... @ $ 20.00 <br /> Service change only in an existing residence ........................... @ $ 20.00 <br /> Commercial or InduStrial: <br /> Service not over 100 amperes ....................................... @ $ 30,00 <br /> Service over 100 amperes =ut not more than 200 amperes ................. @ $ 50.00 <br /> Service over 200 amperes but not more than 400 amperes ................. @ $ 70.00 <br /> Servlceover400emoeresbut not morethen600amperes ................. @ $ 100,00 <br /> Serviceover600amperes ......................................... @ $ 130.00 <br /> __ Serviceover600volts ............................................. ~ $ 300.00 <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br /> InstallStion of AlterStione or Relocation of Distribution Feeders: <br /> Notmorethan 100amperes ........................................ @ $ 20.00 <br /> Over 100 amperes but not more than 2OO amperes ....................... @ $ 30.00 <br /> Over 200 amperes but not more than 400 amperes ....................... @ $ 50,00 <br /> Over 400 amperes ............................................... @ $ 60.00 <br /> Feederover600volts ............................................. @ $ 80,00 <br /> MISCELLANEOUS <br /> A. Each trailer or mobile home space ($e~'l~ e;ulsmem) .................. @ $ 20-00 <br /> B. Each supply for mobile home (Co,~nectioof ........................... @ $ 20,00 <br /> C. Each irrigation pump (Attach e map showing ]Oc~ion) ................... @ $ 20,00 <br /> __ D. Eachelectricsignorouglnelighting ............................... @$ 20.00 <br /> __ E. Each residential swimming pool ................................. @ $ 20,00 <br /> BRANCH ClRCUIT~ <br /> One cew circuit: alteration or extension ............................... @$ 15,oo <br /> __ Two or more new cimuits: alterations or extensions ...................... @ $ 20.00 <br /> __ Other (as per NEC and Building Official) ......................................... <br /> __. On-Site Technical Review apply directly st Marion County only) ..................... <br /> Industrial Plant Inspec[ion (apply directly at Marion County only) ..................... <br /> Reinspestion Fee .......................................................... <br /> FEE ,.<~ O~ ~ ~ <br /> STATE SURCHARGE <br /> Please return COMPLETE APPLICATION PLAN REVIEW FEE <br /> with the indicated fee. NVESTIGATION FEE <br /> TOTAL <br /> <br />SrGNATURE OF APPLICANT' <br /> <br />[] HOMEOWNERS - I hereby certity that I am the owner of the ~reper'~y described above, et which location I propose to make an elestdcal installation for <br /> my own use and this property is not being constructed for sale. lease or rent, <br /> <br />$1GNATURE OF APPLICANT;. <br /> <br />Rev. 3/87 <br /> <br /> <br />