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Received <br />Date; <br /> <br />MARION COUNTY.~BUI~DING INSPECTION <br /> Senator Bldg. I~. 225 <br /> 220 HI.~ Street NE <br /> Salem~ Oregon 97301 <br /> <br /> Shone 588-5147 <br /> Code-A-Phone 4;30 RM, -8:00 A,M, <br /> <br />ELECTRICAL PERMIT APPLICATION <br /> <br />Owner: Phone: Mailing Address; <br /> <br /> istration No.: <br /> <br />Supervising Useof Residential ~ New [] Addition [] <br />EJectricJan~ NO.'.,, Building; Commercial[] I Alteration [] Relocation [] <br /> <br />Occupancy <br />Change <br /> <br /> No. RESIDENTIAL <br />.___ Residence wiring less than 1000 sq. ft ................................. @ $ 50.00 <br />__ Residence wiring less than 2000 sq. ft ................................. @ $ 75.00 <br />__ Residence wiring over 2000 sq. ft .................................... @ $ 105,00 <br />__ EJecthc heat installation in existing residence ........................... @ $ @0,00 <br /> SERVICES <br />/ Temporary Construction Service ................................... ~ $ 30.00 <br />__ Service change onlyin an existing residence ........................... @ $ 30.00 <br /> Commercial or Industrial: <br />___ Service net over 100 amperes ....................................... @ $ 45,00 <br />__ Service over 100 amperes but not more than 200 amperes ................. @ $ 70.00 <br />__ Serviceover200amperesbutnotmorethan400amperes ................. @$ 100,00 __ <br />__ Serviceover400amperesbutnotmorethanS00amperes ................. @ $ 150,00 <br />...... Service over 600amperes ......................................... @ $ 200.00 <br />__ Service over 600 velt5 ............................................. _(-~ $ 450.00 <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br /> Installation of Alterations or Relocation of Distribution Feeders: <br />__ Not more than 100 amperes ........................................ ~_A_') $ 25,00 <br />__ Over 100 amperes but not more than 200 amperes ....................... @ $ 40,00 <br />__ Over200amperesbutnotmorethan400amperes ....................... @$ 70.00 <br />__ Over400amperes ............................................... @ $ 85.00 <br />__ FeederoverS00volts ............................................. @ $ 120.00 __ <br /> MISCELLANEOUS <br />__ A, Eachtrailerormobilehomespaca($ervioeequlprnenb .................. @$ 25,00 <br />.___ B, Each supply for mobile borne (Connection} ........................... @ $ ;~5,00 <br />_____ C, Eachirdgationpurnp{Attachamapshowinglooatlon) ..................... @$ <br />.......... D, Each electric sign or outline lighting ................................ (~ $ 30.00 <br /> E. Eachswimming pOOl (bonding) ................................... @ $ 30.00 <br /> BRANCH CIRCUITS <br />___ Onenewclrcuit;alterationorextension ............................... ~$ 20,00 <br />........ Twoormorenewcircuits;alterationsore×tensions ....................... @$ 30,00 __ <br /> Other (as per NEC and E~uildlng Official) ......................................... <br />__ On-Site Technical Review (apply directly at Marion Coucty only) ...................... <br />__ Industrial Plant Inspection (apply directly at Marion County only) ...................... <br />.......... Reinspection Fee ................................................ @ $ 20.00 <br /> FEE <br /> STATE SURCHARGE <br />Please return COMPLETE APPLICATION PLAN REVIEW FEE <br /> <br /> with the indicated fee, INVESTIGATION FEE <br /> FLEET SURCHARGEToTAL $ <br /> <br /> af~ee omake heeem ca naa a on accodng o he ubm e0p~nsar~ds cc heaws fthe t <br /> <br />[] HOMEOWNERS[ - I hereby ce~ify that I am the owner of the property described above, at which Ioca~on I propose to make an electrical installation for <br /> my own use and this property is not being constructed for se]e, lease or rent. <br /> <br />SIGNATURE OF APPLICANT: <br /> <br /> <br />