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MARION COUNTY BUILDING INSPECTION <br /> <br />PERMIT APPLICATION <br /> <br />Electrical Contractor=$ No <br /> <br />Phone:; <br /> <br />Site No :: <br /> <br />Phone:: <br /> <br />Cross Street;: <br /> <br />Phone Addmss <br /> <br /> Home BuiJder:s Registration No:: <br /> <br />"~g -- Lleeo~.. J~ /~,~ " Reeideht[~l ~ New ~ Addition [] Occupancy <br /> Electrician:s NO Bu~ldmg::F,,¢~,4~¢¢~ Commercial [~ Alteration [] Relocation ~J Change [] <br /> <br /> ! <br /> RESIDENTIAL <br /> Residence wiring less than 1000 sq ft (_-¢ $ <br /> Residence wiring less than 2000 sq ft @ $ <br /> __ Residence wiring over 2000 sq ft (q~ $ <br /> Electric heat installation in existing residence @ $ <br /> SERVICES <br /> <br />NO, <br /> 5000 __ <br />____ 7500 <br /> 10500 __ <br /> $0 O0 <br /> <br /> L TemporaryCon~tructionService ¢$ 3000 __ <br /> .... Service change only in an existing residence @ $ $0 00 <br /> Commercial or Industrial;: <br /> <br /> Service over 100 amperes but not more than 200 amperes (z¢) $?0 O0 <br /> __ __ Serviceover2OOamperesbutnotmorethan4OOa, mperes @$ 100,00 <br /> <br /> __.. ServioeoverC00amperes ~,$ 20000 <br /> ..... Service over 600 volts ~, $ 450,,00 <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br /> I~stallatioe of Alteratioee or Relocation of Diatributloe Feeders: <br /> Not more than 100 amperes ((~$ 25,00 <br /> __ Over lO0 amperes but not more than 200 amperes (~ $ 40 00 __ <br /> Over ~00 amperes but not more than 400 amperes @$ 7000 <br /> Over400amperes (~b$ 8500 __ <br /> , Feederover600volts ¢ $ 120 00 <br /> MISCELLANEOUS <br /> A EaohtrailerormobJJehomsspacefServiceequipmonb ¢~,$ 2500 <br /> __ B Eachsapplyformcbilebome(Connectton) (?~$ 2500 <br /> <br /> __~ D Eachelectricsign or outlinelighting @ $ $000 <br /> ___ E Each swimming pool (bonding) ~/$ 30 00 <br /> <br /> __ One new circuit, alteration or extension ~' $ 20 00 <br /> ___ Two or more new circuits; alterations or extensions (~ $ 3000 <br /> __ Other (as per NEC and Building Ottiei~g <br /> -- ._Z On-Site Technical Review apply directly at Mari0d County onlyl <br /> __ industrial Plant Inspection (apply directly at Marion County only) <br /> __ Reinspection Fee (~ $ 2000 __ <br /> FEE ~ <br /> STATE SURCHARGE ..... <br /> Please return COMPLETE APPLICATION .(D.~ ~~-~ /;, ..~0 <br /> (.,/ INVESTIGATION FEE <br /> with the indicated fee,, FLEETSUROHARGE __--.~,,~- <br /> TOTAL$ . _.~.~,4~ .__ ..... <br /> <br />lagree croaks heeec ca nsa a onaooodngto ~losubm edpansandspe¢ ca onE: ho a~o heS~eofOrogonand heOrdn~ncoso MarionCouny <br />SIGNA'CURE OF A~PL~CANT __ J O b ~ o: <br /> <br />'~.,HOMEOWNERS - I hereby certify that I am the owner of the property described above, at which location I propose to make an electrical installation for <br /> <br />MC 15-34 <br />Rev 12/88 <br /> <br /> <br />