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Received By; <br /> <br />Owner:/' // <br /> <br />.~ ~,.~ .]'~'-- Phone: Address: <br /> Cross Street: <br /> <br />Use of Addition [] <br />Building: Alteration [] Relocation [] <br /> <br />Oscupancy <br />Change [] <br /> <br /> NO, RESIDENTIAL <br />__ Residencewidnglessthanl000sq, ft ................................. @$ 30.00 <br />.__ Residence Wiring less than 2000 sq. ff ................................. @ $ §0,00 <br />__ Resideecewidngover2000sq, ft .................................... @$ 70.00 <br />__, Electric beat installation in ex[atleg resldeeoe ........................... ~. $ 20,00 <br /> SERVICES <br />__ TemporaryConstructionService ..................................... ~__$ 20,00 <br />__ Service shange only in an existing residence ........................... @ $ 20,00 <br />Commen=ial or Industrial: <br />__ Service not over 100 amperes ....................................... @7 $ 30,08 <br />_,__ Serviceoverl00emperesbstnotmorethan200ampems ................. @$ 50.00 <br />__ Service over 2O0 amperes but not mom thee 400 amperes ................. (q) $ 70.00 <br />__ Serviceover40Oamperesbutnotmoretban600amperes ................. @ $ 100:00 <br />.... Serviceever 600amperes ......................................... @ $ 130,00 <br />__ Servlceover60ovolts ............................................. C~) $ 3oo,oo <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br />installation of Alterations or Relocation of Distribution Feeders: <br />__ Notmorethanl00amperes ........................................ @$ 20.00 <br />Over 100 amperes but not more than 200 amperea ....................... @ $ 30,00 <br />__ Over 200 amperes but not more then ~,00 ampere~ ....................... @$ 50.00 <br />__ Over400ampems ............................................... @ $ 60.00 <br />__ Feederover600volts ............................................. @ $ 80.00 <br /> MISCELLANEOUS <br /> <br />,~, Each trailer or mobile home apace (Service equipment) .................. @ $ 20.00 <br />B. Each supply for mobile home (Connection) ........................... @ $ ~'0.00 <br />C. Each irrigation pump (Attach a map shOwing location) ..................... @ $ 20.00 <br />D, Eacll electric sign or outline lighting ................................ Ca) $ 20,00 <br />E. Each residential swimming pool .................................. @ $ 30,O0 <br /> BRANCH CIRCUITS <br />One new cimuit; alteration or extension ............................... @ $ 15,00 <br /> <br />__ TwoormorenewcJrceits;alterationsorextensions ....................... @$ 20.00 <br />__ Other (as per NEC and Building Official) ......................................... <br />-- On-Site Technical Review (apply directly at Marion County only) ...................... <br />__ Industrial Plant Inspectioe (apply directly at Madon County only) ...................... <br />__ Reinspeetion Fee .......................................................... <br /> FEE <br /> STATE SURCHARGE <br /> <br /> Please return COMPLETE APPLICATION PLAN REVIEW FEE <br /> with the indicated fee. - INVESTIGATION FEE i:: "~- / <br /> FLEETSURCHARGE <br /> TOTAL <br />~ ~gtee to make the electrical Installation acc~the submitted plens,~nd specg~catio~s, the laws 0f the ,~tete of Oregon and the Ordinances of Marion County. <br /> <br />[] HOMEOWNERS - I hereby certify that I am the owner of the properly described above, at which location I propose to make an electrical installation for <br /> my own use and th~s property is not being constructed for sale, lease or rent, <br /> <br />SI~INATURE OF APPLICANT: <br /> <br />MC 15-34 (Owner doing ha own wo~k) <br />Rev, $/87 <br /> <br /> <br />