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~ 220 High Street NE <br />BUILBINB INS?£f, IION ELECTRICAL PERMIT APPLICATION'. <br /> <br />Situs Address: Site No_' ~7 Crdss Streot ' <br />7515 ~oe,'t Rd, Aumsville .......... ~) ~' ", '.' ,' · ',: ,,. , <br />Ele~rical Firm: ·Phone: Address: '. ' ,'. ~: ' ' , ' :, <br />Q~a~ glec~[~c .............. 362-419~ "['~:7~ '35~ AV~ ~' , <br />Ele~rical Contra~or~ No,: Home Buildef~ Registration N9.:~'~ ~ . ~ ~ <br />492 /"3 · ~[ ~ ' ' <br />2742C, 4 <br />Supervising Use of ' New '" ~ ..... Addition ' ' '~,, , Occupancy <br />Electrlcian~ No': 2748S ...... <br /> Bud ng: A terat on ~ Relocation ~ Change <br /> <br /> No. RESIDENTIAL <br /> Residence wiring less than 1000 sq. ft ................. @$ 30.00 <br /> __ Residence wiring less than 2000 sq. ft ........... ' ...... . <br /> : ...... ~$ 50,00 <br /> Residence wiring over 2000 sq. ft <br /> @$ <br /> 70.00 <br /> Electric heat installation in existing residence .:... ...... @ $ 20,0(3 <br /> SERVICES <br /> Ternporery Construction Service .................................... @ $ 20,00 <br /> __ Se~vicechangeonlyinanexlstlngresldence ................. ......... @$ 20;00 <br /> Commercial or industrial: <br /> Service not over 100 amperes ....................................... @ $ 30.00 <br /> Service over 100 amperes but not more than 200 amperes ., @ $ 50.00 <br />___ Service over 200 amperes but not more than 400 amperes ................. @ $ 70.00 <br /> Serviceover4OOamperesbutnotrnorethenTOOamperes ................. @ $ 100,00 <br /> ServiceoverTOOarnperee ......................................... @ $ 130.00 <br /> Servlceover 600volts ........................................... @ $ 300.00 <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br /> Installation of Alterations or Relocation of Dletrlbutlon Feeders: <br /> Not more than 100 amperes ........................................ @$ 20.00 <br /> Over 100 amperes Put not more than 200 amperes ....................... @ $ $0.00 <br /> Owr 20D arnperes but not more than 400 amperes ....................... @$ 50,00 <br /> Over 400 amoeres .............................................. RS 60.00 <br /> Feederover$00volts ............................................ @ S 80.00 <br /> MISCELLANEOUS <br />__ A, Eechtrailerorrnobilehomespace(Se~vlceequipmsrrt) , ................. @$ 20,00 <br /> g, Eachsupply{orrnobilehome¢connection~ ......................... @$ 20.00 <br /> C, Each irrigation pump (Attach a map sr~owlng location) ................ ~ .... @ $ '. 20.00 <br /> D. Eachelectrlcsignocoutline.lighting ................ .....'....-..,~.~ .,~J.~$, 20L00, <br /> E. Each residential swimming pool ................................. @ $ 20.00 <br /> BRANCH CIRCUITS <br />~ Oneoewclmuit;alteretionorextension ............................... @$, 15~00 <br /> Two or mom new circuits: aiteratione or extensions ............. @$ 20:00 <br /> Other tas per NEC and Building Officiat) ......................................... <br /> On-Site Technical Review (apply directly at Marion County only) ...................... <br />__ Industrial Plant Inspection (apply directly at Marion County on y) <br /> Reinsoection Fee ........................................ : ....... ' ' ' TM '"' '" ' <br /> ........ : ..... ,: <br /> <br /> STATE. SURCHARGE' <br />Please return COMPLETE APPLICATION <br />with the indicated fee, <br /> <br />agree to make the ele~ricaJ In,~a~et~a~ acCOrding to the submitted plans an~ecifieations the rews ~ Marloff Count. <br /> <br /> HOMEOWNERS - I hereby ce~l~ that I am the owner of~pmpe~ de~r <br /> ~nstalletion <br /> for <br /> <br />Rev, 3/87 <br /> <br /> <br />