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Received g <br /> <br />i':! M-~ION COUNTY,BUILDING NSPECTION <br /> <br />~ ': ~ ':q ......~_C~IC I ELECTRICAL PERMIT APPLICATION <br /> <br />~ ~0/~ j~wn r: '" 0 ~ ~,['~ Phone: '" Gross Street: Mailinfl Address: ......... <br />ElectricatOont actor NO.: "~meBuilder~ <br /> <br />Su~ervi~i ~o of Residential D New ~ Addition D O~upancy <br /> <br /> No. RESIDENTIAL <br /> __ Residence wiring less than 1000 sq, ft ................................. ~.~ $ S0,O0 <br /> __ Residencewiring lessthan 2000 sq, ft ................................. @ $ 60.00 <br /> __ Resldencewiringover2000sq, ft .................................... @)$ 70.00 <br />__ Electric heat Installation ia existing residence ........................... @ $ 20.00 <br /> SERVICES <br />__ Temporary Construction Service ..................................... @ $ 20.00 <br />..... @erv~ce change only in an existing residence ........................... ~ $ 20.00 <br /> Commemial or Industrlah <br />__ Service not over 100 amperes ....................................... @) $ 30.00 <br />......... Service over 100 amperes but not more than 200 amperes ................. @35 50.00 <br />__ Service over 200 amperes but not more than 400 amperes ................. @ $ 70,00 <br />__ Serviceover400amperosbutnotmorethan000amperos ................. @$ 100.00 <br />__ Service over 600 amperos ......................................... (~_ $ 130.00 <br />__ ServiceoverS00volts ............................................. @7 $ 300.00 <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br /> Installation of Alterations or Relocation of Distribution Feeders: <br />__ Not morethan 100amperes ........................................ @? $ 20.00 <br />...... Over 100 amperes but not more than 200 amperes ....................... @ $ 30.00 <br />__ Over~00amperesbutnotmerethan400amperes ....................... @$ 50.00 <br />.... Over 400 amperes ............................................... rii:, $ 60.00 __ <br /> Feederover600volts ............................................. (~ $ 80.00 <br /> MISCELLANEOUS <br />....... A. Each trailer Or mobile home space (Service equipment) .................. @ $ 20.00 <br />__ B. Each supply for mobile home (Connection) ........................... @ $ 20.00 <br />__. C, EachirrigalJonpump(Attacllamapshowingloc,~tion) ..................... @$ 20.00 <br />....... D. EacheleetricsignoroutlinelightJng ...... ~ ......................... ~i~$ 20,00 <br />__ E, Each residential swimming pool .................................. (~O $ 20,00 <br /> BRANCH CIRCUITS <br />...... One new clroult; alteration or extension ............................... @$ 15.00 <br />.__ Twocrmorenewcircuits;alteratlcnsorextensions ....................... ('o~$ 20,00 <br />__ Other (as per NEC end Suildlng Official) ......................................... <br />__ On-Site Technlcal Re¥iew (apply directly at Marion County only) ...................... <br />__ Industrial Plant Inspection (apply directly at Madcn County only) ...................... <br />__~ Reinspection Fee ................................................ (~. $ 15,00 <br /> FEE <br /> STATE SURCHARGE <br />Please return COMPLETE APPLICATION PLAN REVIEW FEE <br /> <br /> with the indicated fee. (~ INVESTIGATION FEEFLEETSURCHARGE <br /> TOTAL $ ~{,~,,/..~, <br /> <br />[] HOMEOWNERS - I hereby certify that I am the owner of tho property described above, at which location I propose to make an electrical installation for <br /> my own use sad this property Js not being constrscted for sale. lease or rent. <br /> <br />SIG NATURE OF APPLICANT: <br /> <br /> <br />