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Received By <br /> <br />MARION C~OUNTY BUILDING INSPECTION <br /> Senator Bldg. NO, 225 <br /> 220 High Street NE <br /> Salem, Oregon 97301 <br /> <br /> Phone 588-$147 <br /> Code~A-Phone 4::30 RM. - 8:00 A,M,, <br /> <br /> ELECTRICAL PERMIT APPLICATION <br /> <br /> /~(~L~, Phone:: Mailing Address <br />tO -/-'~/'~'-J o~ ross - ~-¢¢/ Site No Cross Street:: <br /> <br />Supervisin~ I trician <br /> <br />Electrical Contractor's NO <br /> <br />Phone <br /> <br />Phone:: <br /> <br />Address <br />Address <br /> <br /> Home Builder's Registration No :: <br /> <br />IUseof Residential [] ~ New [] Addition [] Occupar~cy <br /> Buitding Commercial []/ Alteration [] Relocation [~ Change <br /> <br />Supervising <br /> <br />~}ectrician's NO <br /> <br /> No, RESIDENTIAL <br /> Residencewiringlessthanl000sq ft ('d~$ 5000 <br />?__ Residence wiring less than 2000 sq ft (~ $ 75 00 <br />___ Residence wiring over 2000 sq ft (.~) $ 10500 __ <br />. Eleetricheat installation in existing residence t?i, $ 3000 __ <br /> SERVICES <br />____ Temporary Construction Service (~ $ 30 O0 <br />..... Service change only in an existing residence (d) $ 30 00 __ <br /> CommercJel or Induatrial: <br />___ Service not over 100 amperes (~ $ 45 00 <br /> Service over 100 amperes but not more than 200 amperes ((x~$ 7000 <br /> Serviceover20gamperesbutnotmorethan400emperes r~;$ 10000 __ <br /> Service over 400 amperes but not more than 600 amperes (<J$ 150,00 <br /> Service over 600 amperes ('cf) $ 20000 __ <br /> .... Service over 600 volts (~= $ 450 00 <br /> COMMERCIAL AND ~NDUSTR[AL FEEDERS <br /> Installation of Alterations or Relocation of Distributior~ Feeders: <br /> ___ Notmorethanl00amperes ((~=$ 2500 <br />__ Over 100 amperes but not more than 200 amperes s/~ $ 40 00 <br /> Over 200 amperes but not more then ¢00 amperes $ 70,00 <br />____. O¢er400 amperes e¢$ 85 0g <br />_. Foeder o~er 600 volts ~ $ 120 00 <br /> MISCELLANEOUS <br />__ A Each trailer or mobile home space (Service equipment} {~: $ 25 00 <br />__ B Each Supplyfor mobile hometOonnect~er~I (iz' $ 25 00 <br />__ C Each irrigation pump (Attach a mapsllowing Iocation) (~i~ $ 3000 <br />._ D Ea~helectricsisnoroutlinelighting tbs 9000 <br />__ E Eachswimmingpool(bondms) ('i¢$ 3000 <br /> SRANCH CIRCUITS <br />__ One new cireei: a oration or exteds on g~: $ 20 00 <br />__ Twoormorenewcirceits;alterationsorexten$ions (¢~$ 2000 <br />__ Other fas per NEC and Buildin9 Official) <br />___ On-Site Technical Review (apply directly at Marion County only) <br />___ Industrial Plant Inspection tapply directly at Marion County only) <br />__ Reinspection Fee (~: $ 20 00 -- <br /> FEE <br /> STATE SURCHARGE <br />Please return COMPLETE APPLICATION PLAN REVIEW FEE <br /> <br /> with the indicated fee. iNVESTiGATION FEE <br /> FLEET SURCHARGE <br /> TOTAL $ <br /> <br />i aSrceto makethe electrical installation a~ the s~~ciflcation s: the ,¢ws of the State of O,'egon and th6~rdinances of Medon County <br /> ¢ Job No <br />SIGNA'¢URE OF APPL,OANT _ /¢{x~ ~ ' _--- ,~. <br /> <br /> HOMEOWNERS - I hereby certi~ that I am the owner of the property described above at which location I propose to make en electrical mn¢talletion for <br /> my own use and this p operty is not be ng cons~ucted for sale e~e or rent. <br /> <br />SIGNATUR~ OF APPLICANT <br />15,,34 (Owner do,ag his own <br />ROy 12/88 <br /> <br /> <br />