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Recek, ed by:. <br />Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> 220 High S~{ NE <br /> Salem, C~ 97301 <br /> Phoce 588~147 8:00 a,m, - 4:30 p.m, <br /> Cede-A-Phone: 588-7904 SITE <br /> FAX: 588-7948 Da~: <br /> <br /> Issued <br /> <br />FOR OWNER IN~TALLA'~ONS <br /> <br />Property Owner <br />Mailing Address ,II Phone <br />C[ly/State/Zlp <br /> <br />The Installa[Ion ia be[rig made on property I own which is not intended for saEe, <br /> <br />Permit No, <br /> <br />4, FEE SCHEDULE (Complete and enter total in A~ below) <br />Number of inepeotions per permit alloWed <br /> <br /> Eae. hadd'lSOOsq, ft, orpertiofl __ $ 15. __ <br />EL .~rvlse~l:eeder$ <br /> <br /> Reconnect Only __ S 00, __ <br />C, Temgamry Servlee~Fecder~ <br /> <br /> Over 600 amps or 1000 volts (Sec 4B) <br /> Oee cimult / $ 00....,"f,~: 6' 0 <br /> <br />(Servia or F~ not inciude~) <br /> <br /> panel, altena/ion or extension __ $ 36. __ <br /> <br /> meabove, perlnq~ecllon __ $ 00, __ <br /> <br /> Pack of 10 labels @ $5,00 each $ 50. __ <br /> (So,~ on(y zo eteea'l~l e~tracte~) <br /> <br /> (As required by ~ildin§ Offi~Jal) <br /> <br />3. PLAN REVIEW SECllON <br /> Chec~ approp/~ate item and enter fee in ~ac#on 5B, <br /> <br />Conneb-ted Load over 200 amps (except single family dwellings) <br />Building system over ~00 amps (except single family dwellings) <br />System over 600 volte <br />Building over 2 stories <br />Bui~ing over 10,000 Square feet <br />OcoJpant load over 3(30 persons <br />Manufab-temd Dwelling Park/Recreation Park <br />Hazardous Lecations <br /> <br />Submit 2 sets ~ plans with any of me above, <br />Temporary cen[~tl'uction services do not apply. <br /> <br />A~, Enter torsi of fees from Sec, ~t $~ <br />A2. Add S% sor~ha;ga (,05xA~) $ / ?c~- <br /> Subtotal $. <br /> <br />B. Enter 25% of line A1 fo~ Plan Review <br /> (Sec~ 3), if mquimcl <br />C. Investigation Fee (if required) <br />D. Reinq~on Fee ($25.00) <br /> <br /> TOTAL AMOUNT DUE <br /> Recelpt No. <br /> <br />$ <br />$ <br />$ <br /> <br /> <br />