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Received By:: __ <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> ¢~- Senator Bldg,, No. 22S <br /> 220 High Street NE <br /> Salem~ Oregon 97301 <br /> <br />Job Address <br /> <br />Super¥isi~ E~ctrician /¢ / <br /> <br />E~eot;~l~ontra6tor:~ No --' ~ <br /> <br />ELECTRICAL PERMIT APPLICATION <br /> I Phone Meiling Address:: <br /> Site NO Cross Street:: <br /> <br /> Phone Address, <br /> Phone:: Address <br /> <br /> Home Builder's Registration No <br /> <br />Supervising T Use of Residential [] New [] Addition [] Occupancy <br />Electrician's No /Building:: Commercial [] Alteration [] Relocation [] Change [] <br /> <br /> NO. RESIDENTIAL <br /> Residence wiring less than 1000 sq ft (_~z? $ <br /> Residence wiring less than gO00 Sq ft @ $ <br />__ Residencewiringover~000sq ft @ $ <br />__ Electric heat installation in existing residence ~'s $ <br /> SERVICES <br />__ Temporary Construction Service (~, $ <br />___. Service change only in an existing residence (a~ $ <br />Commercial or Industrial: <br />_. Service not over 100 amperes (¢~ $ <br />__ Service over 100 amperes but not more than 200 amperes (¢ $ <br />Service over 200 amperes but not more than 400 amperes ¢~$ 10000 <br />-- Serviceovere00amperesbutnotmorethanC00amperes (Ez$ 15000 <br />__ Service over 600 amperes .... @ $ 20000 <br />__.Service over 600 volts....... Fd~ $ 45000 <br /> COMMERCIAL AND iNDUSTRIAL FEEDERS <br />Installation of Alterations or Relocation of Distribution Feeders: <br />___ NOt morethan 100 amperes @ $ 25 00 <br />Over 100 amperes but not more than BOO amperes ~' $ 40 00 __ <br />Over 200 amperes but nor more than 400 amperes Ri:, $ 7000 __ <br />.... Over 400 amperes @$ 8500 <br />___ Feeder over 600 volts (ct, $ 12000 <br /> MISCELLANEOUS <br />___ A Each trailer or mobile home space Serwce equipment (~ $ 25 g0 __ <br />B Each supply for mobile home (Conneotiom (~' $ 25 00 <br />__ O Eachirrigationpsmp(Aeachamapshowinglooatton) (~,$ 3000 __ <br />...... D Each eJeotrio sign or outline lighting ~_,, $ 30 00 <br />__ E Eaohswimmingpool(bonding) (b~$ 3000 <br /> BRANCH CIRCUITS <br />___ Oeenewcircuit;alterationorextension ('r¢'$ 2000 <br /> Two or more new circuits, ~lterations or extensions ¢ $ 30 00 <br /> Other (as per NEC and Building Official) <br />....... On-Site Technical Review (apply directly at Marion County only) <br />__ Industrial Plant Inspection (apply directly at Marion County only) <br />__ Rsinspection Fee (d, $ 2000 <br /> <br /> STATE SURCHARGE <br />Please return COMPLETE APPLICATION PLAN REVIEW FEE <br /> <br /> 5O 00 <br /> <br />105,00 __ <br /> 30 00 <br /> <br /> 30 O0 .... <br /> 30 O0 <br /> <br />4500 <br />70 00 <br /> <br /> with the indicated fee INVESTIGATION FEE <br /> FLEET SURCHARGE .(.~? <br /> TOTAL <br /> $ <br /> <br />~ ROMEOWN~I~S - I hereb~ certif~ lhet I am the owner of the property described a~ove~ at which location I Ompose to make an electrical install~tion for <br /> my own use and this property is not being constructed for sale lease or rent <br /> <br />SIGNATURE 0¢ APPL CANT __ <br /> <br /> <br />