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Received Sy;: <br />Date <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br />ELECTRICAL PERMIT APPLICATION <br /> <br />........ Rex Luca$ 749-2576 575 O~l~ke~ Street S.E. <br />Situs Address Site No,,;; Cros~Street: .... <br />Electrical Firm Phone:: Address:: <br />'Supervising Electrician;: Ph0~e r . v , <br />R~nh~ 1~,~ 370-9278 1606~k Street S.E. <br />Electrical Contractor's NO :; Home Builder's Registration No,,;; <br />24-139c 34296 <br />Supervi'~ing Use of ................... New [] Addiiion [] Occupancy <br />Electriciee~Ne,,;; 2375s Building:: Residence Alterationfq Relocation [] Change <br /> <br />No. <br /> <br /> RESIDENTIAL <br />Residence wiring less than 1000 sq ft .............. @ $ <br />Residence wiring [ess than 2000 sq ft ........................... @ $ <br />Residence wiring over 2000 sq ft ............................... @$ <br />Electric heat Installation in existing residence ............... @ $ <br /> SERVICES <br />Temporary Construction Service ................... @ $ 20,00 <br />Service change only in an existing residence ................. @ $ 20.00 <br />Commercial or Industrlah <br />Servicenotoverl00ampems ........................... @ $ 3000 <br />Service ever 100 amperes but not mere than 200 amperes @$ 5000 <br />Service over g00 amperes but cet me~e than 400 amperes ............ @$ 70,00 <br />Serviceover400amperes~utcet morethanS00ampares ................ (__¢ $ 10000 <br />Servtaeover 60gamperes .................. @ $ 130.oo <br />Service over 600 volts ........................ @_ $ 300,00 <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br />Installation of Alterations or Relocation of Distribution Feeders: <br />Ncr more than 100 amperes ......................... L'~. $ 20,00 <br />Over 100 amperes but cat more than 200 amperes .................. @$ 30,00 <br />Over 200 amperes but not more than 400 amperes ................ @ $ 5000 <br />Over400arepams .................................... @ $ 60.00 <br />FeederoverC00volts ............................................ @ $ 8000 <br /> MISCELLANEOUS <br />A, EachtrailerormobiJehemespace($ervleeequfpment) .................... @$ 2000 <br />B, EachsupplyforreObilehome(Connection) ................... @$ 20.00 <br />C, Each irrigation pump (Attach ~ m~p ~howing Iocatlort) ........... ~. $ 20,00 <br />D, Each electric sign er outlinelighting ........................ @ $ 2000 <br />E. Each residential swireming pool ...................... @ $ CO,,00 <br /> BRANCH CIRCUITS <br />One new cireait; altsrat]on or extension ............... @$ 15,00 <br />'Eve or reore new circuits, alterations or extensions ............... @ $ 2000 <br />Other (as per NEC and Building Official) <br />On-Site Technicel Review (apply directly at Marion County only) <br />Industrial Pleat Inspection (apply directly at Marion County only) <br />Reinspection Fee <br /> FEE <br /> STATE SURCHARGE <br /> <br />30.00 <br />~0,00 5p,. oo <br />7O.00 <br />20.00 <br /> <br /> 50.00 <br /> 2.50 <br /> <br /> Please return COMPLETE APPLICATION PLAN REVIEW FEE <br /> with the indicated fee. INVESTIGATION FEE <br /> FLEET SURCHARGE $__~qL i <br /> TOTAL ........ <br /> I agree to make the electrical ins~din~t'~ the s~ffe~ e~4C~flcations: the laws of the State of Oregon and the Ordinances Of Marion County <br />SlGNATURE OF APPLICANT ,.~L.~, ./"k~"--,.~['~--~.-~. ~/ /-~a~-.~- ,, <br /> <br />[] HOMEOWNERS - I hereby certify that I am the owner of the property described above, at which location I propose to make afl electrical installation for <br /> my own use and this property is not being constructed for sale, lease or rent <br /> <br />MC 15-34 <br />Rev 3/87 <br /> <br /> <br />