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Received <br />Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br />Sen~or Bldg. No- 225 <br />220 High Street NE <br /> Salem, Ol~]on 97301 <br /> <br /> Pllone S88.5147 <br /> Code-A-Phone 4;30 P.M, - 8:00 A,M. <br /> <br />ELECTRICAL PERMIT APPLICATION <br /> <br />SitusA~b ~. r~~ .0~ ~ite NO.: Crce, Ot~e,: <br />Electrical Firm: ~/ / Phone: Address: <br />Supe~ising Electrician: Phone: Address; <br /> <br />E~ectrical Contractor~ NO.: Home Builder~ Registration No,: <br /> <br />Supervising ............. U~e of New ~ ~ Addition ~ Occupancy <br />Eie~rician~ NO,; .......... Bud nC: Alteration ~ Relocation ~ Change <br /> <br /> No. RESIDENTIAL <br />__ Residencewiring lessthan 1000 sq. ff ................................. @ $ 30.00 <br />___ Residencewiringless than 2000 sq. ft ................................. @ $ 50,00 <br />__ Residencewlringover2000sq. ft .................................... @$ 70.00 <br />__ Electric heat installation in existing residence ........................... @ $ 20.00 <br /> SERVICES <br />-- Temporary Construction Service ..................................... @ $ 20,00 <br />__ Service change only in an existing residence ........................... @ $ 20,00 <br /> Commen~lel or Industrlslt <br />___ Servicenotoverlg0amperes ....................................... @$ 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 />__ Serviceover400amperesbutnotmorethan600amperes ................. @ $ 100,00 <br />__ Ssrviceover600amperes ......................................... @ $ 130,00 <br />__ Service over 600 volts ............................................. @ $ 300.00 <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br /> Installation of AIterstione or RelocatiOR of Distribution Feeders: <br />__ Not morethan 100amperes ........................................ @ $ 20,00 <br />__ Over 100 amperes but not more than 200 amperes ....................... @ $ 30.00 <br />__ Over 200 amperes but not more than 4.00 amperes ....................... @ $ 50,00 <br />__ Ovor400amperes ............................................... @$ 60.00 <br />__ Feederover600voits ............................................. @$ 80,00 <br /> MISCELLANEOUS <br />.~, A, Each trailer or mobile home space (Service equipment) .................. @ $ 20,00 <br /> B. Esch supply for mobile home (Connection} ........................... @ $ 20,00 <br />__ C. Each irrigation pump (Attach a map showing location) ..................... @ $ 20.00 <br />__ D. Eachelectdcsi§noroutline[ighting ................................ @$ 20.00 <br />__ E. Each resJdential swimming pooi ., ................................. @$ 20,00 <br /> BRANCH CIRCUITS <br />__ Onenewcircuit;alterationorextension ............................... ~}$ 15.00 <br />__ Twoormorenewcimuits;alteratloceorextensioce ....................... @$ 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 st Marion County only) ...................... <br />__ Relnspectlon Fee .......................................................... <br /> FEE <br /> STATE SURCHARGE <br /> <br />Please return COMPLETE APPLICATION <br />with the indicated fee. <br /> <br />I acme to make the electrical Installatio <br />$1G NATU RE OF APPLICAN~,~ <br />~'~HOM EOWNERS - I he <br />V ~St own use and this prepert~ is <br /> <br />SrG NATURE OF APPLICANT: <br />MC 1~-$4 <br />Rev. 3/87 <br /> <br /> ~ FLEET SURCHARGE .~5~.,{:, v/ <br /> <br /> ~,ans a~ ~e Stare of Oregon and the Ordinsnge~o:Mari'~n Count~.~ ~ <br /> ~*d~r~d~b°Ve--at which location I propose to make an ele~dcal installation for* <br />1 am the owne~ ~e <br /> <br /> <br />