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COUNTY BUILDING INSPECTION <br /> Senator Bldg, No. 225 <br /> 220 High Street NE <br /> Salem, O~egon 9730~ <br /> <br /> Phone 58~147 <br /> Code-A-Phone 4:$0 RM. - 8:00 A.M. <br /> <br /> MARION C0UN'r¥ <br />BUILDING [N p ,GTII ECTRICAL PERMIT APPLICATION <br /> <br /> ' ....... Phone; Address: <br /> <br />Ele,~;~l Firm; _ ~ .~ '-' Phone; Address; ~,~-~ <br /> ' Addr~ /~ , <br /> <br /> Home ~uilder'~ Regi~rAt[~ No~ ~ ./ ' <br /> <br />Super[sing Use ol ~ ~w ~ Addition : Occupan~j .............. <br /> Ch~nge~ <br /> <br /> / <br /> NO. RESIDENTIAL <br />__ Residencewldngleasthanl000eg. ft ................................. @$ 30.00 <br />__ Residencewiringlessthan2000sg. ft ................................. @$ 50.00 <br />__ Residence wiring over 2000 sq, 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 /> Commercial or Industrial: <br />¢ Service not ever 100 amperes ....................................... @ $ 30.00 <br />__ Service over 100 amperes but net mere than 300 amperes ................. @ $ 50.00 <br />__ Service over 200 amperes but net more than 400 amperes ................. @ $ 70.00 <br />__ Service ever 400 amperes but nOt more than 6,00 amperes ................. ~_~ $ 100.00 <br />__ Serviceover600amperes ......................................... @75 130.00 <br />__ Serviceover600volts ............................................. @ $ 300.00 <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br /> fnetaflation of Alterations or Relecstlon of Distribution Feeders: <br />__ Not morethan 100amperes ........................................ @ $ 20.00 <br />__ Overl00amperesbutnotmorethan200amperes ....................... @$ 30.00 <br />__ Over300emperesbutnotmorethan400ampems ....................... @$ 50.00 <br />.... Over 400 amperes ............................................... @ $ 60,00 <br />__ Feederover600velrs ............................................. @ $ 80.00 <br /> MISCELLANEOUS <br />__ A, Eachtrailerormobilehomespace(Serviceequipment) .................. @$ 20.00 <br />__ 0, Each supply for mobile home (Connection) ........................... @ $ 30.00 <br />I C, Eachirrigationpump(Attachamapshowinglocatlon) ..................... _~$ 20.0(?' <br />__ D, Eachelectricsignoroutlinelighting ................................ @$ 20.00 <br />__ E. Each residential swimming pool .................................. ~ $ 20,00 <br /> BRANCH CIRCUITS <br />__ Onenewcimuit;alterationorextension ............................... @$ 15,00 <br />__ Twoormorenewcircuits;akerationeorextensions ....................... @$ 20,00 <br />__ Other (as per NEC and Building Official) ......................................... <br />__ On-Site Technical Review (apply directly et Medon County only) ...................... <br />__ industrial Plant Inspectlon (apply dlrectly at Marion County only) ...................... <br />__ Reinspection Fee .......................................................... <br /> FEE <br /> .._~STAT E SURCHARGE <br />Please return COMPLETE APPLICATION PLAN REVIEW FEE <br /> <br /> with the indicated fee. INVESTIGATION FEE <br /> FLEETSURCHARGEToTAL ~ <br /> <br />SIGNATURE °F APPLICANT: ~/ ' / / ~ ~ (S u po rvlslng E~ectrle~a n)~[ <br />~ HQMEOWNERS - t hereby certify/hat" I am the owner of the properly described above, at which location I prop0~e to make an electrical installation for <br /> my own use and this property is ~)~ft bdmg constructed for sale, lease or rent, <br /> <br /> <br />