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Received By; <br /> <br />MARION COUNTY BUILDING INSPECTION <br />· ~netor Bldg. NO. 225 <br />220 Hlgl~ Street NE <br /> Salem. O~egon 973~1 <br /> <br /> .~. ,- Phone 588-5147 <br /> Code-A-Phone 4:30 P.M. - 8:00 A.M. <br /> <br />ELECTRICAL PERMIT APPLICATION <br /> <br />"~Own~r.~,~ ~ ,40 c~,.~) Phone: Mailing Address: <br />JobAddress: ~____?~,~O ~,~ ~ ~g. /~ Site NO.; Cmss Street: <br />Su0erv~iB lo r?an: Phone: Address: <br />Electri~al~ontracto~ NO,: <br /> Home Builder's Registration N'~'~ ...................... ~ <br /> Supervising ' I U~eof Residential ~ New ~ Addition U O~upancy <br /> Alteration ~ Relocation ~ Change <br /> E ectrlcia~ No,; ~ Building' <br /> .. <br /> <br /> NO. RESIDENTIAL <br /> __ Residencewiring less then 1000 sq, ft ................................. @ $ $0,00 <br /> ./ Residence wiring less than 2000 sq. ft ................................. @ $ 50.00 <br /> __ Residencewiringover200gsq. ft .................................... @$ 70.00 <br />__ Electric heat ~nstallatlon in existing msidenoe ........................... @ $ 20,00 <br /> SERVICES <br />.... Temporary Construction Service ..................................... @ $ 20.00 <br />.... Service change only in en existing residence ........................... @ $ 20.00 <br /> Commercial or Industriah <br />__ Service notover 100amperes ....................................... @ $ 30.00 <br />__ Serviceoverl0gamperesbutnetmeretheng00amperes ................. @5 50.00 <br />____ Service over 200 amperes but not more than 400 amperes ................. @ $ 70,00 <br />__ Service over 4OO amperes but not more than 600 amperes ................. @ $ 100.00 <br />__ Serviceover600amperes ......................................... @ $ 130,00 <br />__ Serviceover600volts ............................................. @ $ 300.00 <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br /> Installation of Alterations or Relocation of Dist~'ibuflon 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 400 amperes ....................... @ $ $0.00 <br />.... Over 400 amperes ............................................... @_ $ 60.00 <br />,__ Feederever600volts ............................................. @$ 80,00 <br /> MISCELLANEOUS <br />__ A. EachtrailerormobJJehomespace(SenS~eesulcment) .................. @$ o0,00 <br />__ B. Each supplyfol'mobile home (Connection) ........................... @ $ 20.00 <br />__ C. Eachirrigatlonpump(AttachemeSslSowinglocation) ..................... @$ 20.00 <br />__ D, Each electric sign or outline lighting ................................ @ $ 20.00 <br /> E, Each residential swimming pool .................................. @ $ 20.00 <br /> BRANCH CIRCUITS <br />__ Onenewcimuit;aiterat[onorextenslon ............................... @$ 15.00 <br />__ Two or more new circuits; elteretlo[ls or extensions ....................... @ $ 20.00 <br /> Other (es per NEC end Building Official) ......................................... <br />__ On-Site Technical Review (apply directly et Merle[1 County only) ...................... <br />__ Industrial P~ant Inspection (apply directly at Marion County only) ...................... <br />..... Reinspect[on Fee ................................................ @ $ 15,00 <br /> FEE <br /> STATE SURCHARGE <br />Please return COMPLETE APPLICATION PLAN REVIEW FEE <br /> <br /> ....... iNVESTIGATiON FEE <br /> with [ne ina~ca~ea me. FLEETSUROHARGE <br /> <br /> ag ee to make tho electrical st stallation~.,?5 r ~lZ~/.~o t ~ ~p~e/~ticago~l s, lisa laws Of the ~tate of Oregon and the et dlr~allces Of Marion Co[Jisty' . <br />SIGNATU R E OF APPLICANT'. ~~~~ <br /> HOMEOWNERS - I hereby certi~ that I ~m the owner of the proper~ described above, at which location I p~poge to~ake an electrical installation for <br /> <br />SIG NATU R E OF APPLICANT: <br /> <br /> <br />