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2 <br />~,M~RION COUNTY BUILDING INSPECTION <br /> .~.enator Bldg. NO. 22~ <br /> 220 High Stl'~t NE <br /> Salem, Oregon 9730~ <br /> <br /> Phone 588-$147 <br /> Coae-A-Phone 4:~0 EM. - 6:00 <br /> <br />~.,~K~' .~ u .... ~ ELECTRICAL PERMIT APPLICATION <br /> <br />Owner: ~ T Phone; Address: <br />E~r~ F~rm: ' . Phone: Address: <br />Supe~islng EJectricla~ ~ Phone: Address: <br /> <br />Eie~rical Contracter~ No,: 'Home Builde~ Registration NO,: <br /> <br />Supervising ' Use of New ~ Addition Q Occupa~ <br /> , Relo6atlon. Q Chenge <br />Electrleian~ No.: ~ ~ ~ ~ B¢lding: ] Alteration ~ , <br /> <br /> NO, RESIDENTIAL <br /> Residence wit/ns less than 1000 aq. ft ................................ @ $ S0,o0 <br /> Residence wiring less than 2000 SCl, ft ................................ @ $ 50.00 <br /> ~ Residencewiringover2000sq, ft .................................... @$ 70.00 <br /> Electric heat ~stallatJon in existin¢ 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 amoeres ....................................... @ $ 30.00 <br /> __ Serviceovert00emperesbutnotmorethan200amperes ................. @$ 50.00 <br /> Service over 200 ameeres but not mom than 400 amperes ................ @ $ 70.00 <br /> __ Set"dceover400emperesbutnotmorethena00ameeres ................ @ $ 100.00 <br /> __ Servlceovera00amlseres .................. ~ ...................... @ $ 130.00 <br /> , Servlceovera00volts ............................................ @ $ 300,00 <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br /> Installation of Alterations or Relocation of Distribution Feeders: <br /> Not more than 100 amperes ...................................... @ $ 20.00 <br />__. Overl00empereabutnotmorethan200amperes ................... @$ 30.00 <br />_._ Over200amperesbutnotmorethan400emperes ....................... @$ 50.00 <br />__. Over400emperes .............................................. @$ 60.00 <br />__. Feederover600volts ............................................ ~$ 80.00 <br /> MISCELLANEOUS <br /> A, Eachtre~lerormobilehomear~ace~Se,¥~cee~u~pment) ................. ~ $ 20.00 <br /> -- B Each supplyfor mobile home .Co~neation) ........................... @ $ 20.00 <br /> . C, Each irrige, tion pump Aea~h a map ahowiflg IOcatlor~ ..................... ~. $ 80.00 <br /> D. Eachslectricslgnorouthnelighting ........................ : ........ . @.$ 20.00 <br /> _ E. Each residential swimming pool ......... ...... ; ................ . @:$ 20.00 <br /> BRANCH C RCUITS ' I <br /> . Onenewcircuit:alterationorextension .............................. @$ 15,00 <br /> ~ 'Rvo or more new cimuits: alterations or extensions ....................... @ $ 20.00 ..~_x~,~ ~ ; <br /> Other res per NEC and Buildtn~ Official'~ ......................................... <br /> __. On-Site Technical Review (apply ,~imoby at Marion County only) ...................... <br /> Industrial Plant Inspection (apply directly et M~rion County only) ..................... <br /> Reinspection Fee .......................................................... <br /> FEE <br /> ~" STATE SURCHARGE /. ,~,,-1~' <br />Please return COMPLETE APPLICATION PLAN REVIEW FEE ~ <br />with the indicated fee. INVESTIGATION FEE <br /> FLEET SURCHARGE ¢¢¢, fiL ~,. <br /> TOTAL La --~q, ~ <br /> <br />to me, ks the elect rical instal~ubmltted pl, p n.s and specifications, the laws of the State ot Oregon and the Ordinances of Marion COur)~ <br /> <br />aJGNATURE OF APPLICANT:. <br /> <br /> <br />