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ELECTRICAL PERMIT APPLICATION <br /> <br /> Phone: Address: <br /> E l/Jo , <br /> <br />Electrical Firm; / Phone; Address: <br />KSI.ZE~ EL¢CT~IC~ INC. 378-0267 ~.O. ~OX 7246 SAL~M~ 97303 <br />~perv~slng E~ectdo~an; " Phone: A~dress: <br />MIKE ~ITT~ER <br />""~le~doal Contractor~ No.: ' Home 8uilder~ Reg~ctrefion No.: .... <br /> <br /> 24-68C 1435~ <br /> ~upervisio~ " I' Use~f · New ~ Addition ~ O¢oupacey <br /> ~elceatlon ~ . .O~ange ~ <br /> Ele~ciansNo,:, 15'79S .... ]-BU d~g ' : Altsration~, <br /> <br /> No, RESIDENTIAL <br /> Residence wiring less than 1000 sq. ft ................................. @$ 30.00 <br /> Residence wiring less than 2000 sq f~ ................................. @$ 50.00 <br /> Residence wiring over 2000 sa. ft .................................... @ $ 70.00 <br /> Electric heat installation in existing residence ........................... @ $ 20.00 <br /> SERVICES <br /> Temporary Construction Service ..................................... @ $ 20.00 <br /> Service change onty in sn existing residence ........................... @ $ 20,00 <br /> Corcmemlal or Industrial: <br /> Service not over 100 amceres ....................................... @$ 30.00 <br /> Service over 100 amperes but not more than 200 amperes ................. @ $ 50,00 <br /> Service over 200 ameeres but not more tban 400 amperes ................. @ $ 70.00 <br /> Service over 400 arcceres but not mare than 600 amperes ................. @ $ 100.00 <br /> Service over 600 amperes ......................................... @ $ 130.00 <br />__ Service over 600 volts ............................................. @ $ 300.00 <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br /> Installation of Alterations or Relocation of Distribution Feeders: <br /> Not morethan 100 amceres ........................................ @ $ 20.00 <br />__ Owr 100 amperes but not more than 200 amperes ....................... @ $ 30.00 <br /> Over 200 amperes but not more than 400 amperes ................... @ $ 50.00 <br />__ Over4g0amperes ............................................. @$ 60.00 <br /> Feederover600vots ........................................ @ $ 80,00 <br /> MISCELLANEOUS <br /> A, Each trailer or mobile home space (Servi=e e~u[pmen[) ................. ~ $ 20,00 <br /> B. Eachsupp]yformobl[ehome~¢onnectlon/ .......................... @$ 20.00 <br /> C. Eachlrrlgatlonpump(Atl~a~l~amapsl~owing~ocation] ........ ~. $ 20.00 <br /> D, Eachelectrlcsignoroutlinelighting ................... iiiii., iiiii ~ $ 20.00 <br /> E. Each residentiaIswimming ppol ..................... @ $ 20.00 <br /> BRANCH ClRCUITE; ' ' <br />_J__ One new circuit: alteration or extenslor ............................... @ $ 15.oo <br /> TWO or more new circuitS; aitsrations or extensions ....................@ $ 20,00 <br /> Other [as per NEC and Building Official) ........................................ <br /> On-Site Technical Review (apply directly at Marion County only) ...................... <br /> Industrial Plant Inspection (apply directly at Marion County only) ..................... <br /> Reinspection Fee ................................................ ~;' <br /> STATE SURCHARGE <br />Please return COMPLETE APPLICATION PLAN REVIEW FEE <br />with the indicated fee. INVESTIGATION FEE <br /> FLEET SURCHARGE <br /> TOTAL <br /> <br /> agree to mane the electrical installation a~ording to the submit plans and specifications the s of tb~ ~te al <br /> <br />~ HOMEOWNERS - ~ hereby ~rt[~ that I am the owner of the pmpe~ described a~ve= at which I~ation propose to make an electrical Inst~llatlon fo~ <br /> my own use and this pmpe~ is not being ~nstru~ed for sale, lea~ or rent, <br /> <br />31GNATU RE OF APPLICANT: <br /> <br />MC 15-34 (Owner dglng his ewnwgm~ <br />ReV. 3/87 <br /> <br /> <br />