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MARION COUNTrY. BUILDING INSPECTION <br /> ~fl~.tor BId~. HO. 2~ <br /> 220 High Street NE <br /> Salem, Oregon 97301 <br /> <br />ELECTRICAL PERMIT APPLICATION <br /> <br />Owner Phone Mailing Address:: <br /> <br />JobAddmss <br /> <br />Cross Street' <br />Address:: <br /> <br />Address:: <br /> <br /> ! ~_/~.¢ Home Builder's Regist ratio~_o~,~ ,4~'-4~~'~' <br /> <br />Supervising I Use of Residentia, I L~ New [] <br /> Commemial [] Alteration [] <br />E,ectrician's No/¢~ y,~ Building <br /> <br />NO. RESIDENTIAL <br /> <br />Addition [] Occupancy <br />Relocation [] Change <br /> <br />___ Residencewlrlnglessthan 1000sq ft ......... <br /> Residence wiring less than 2000 sq ft @ $ <br />__ Residence wiring over ~000 sq ft ~ $ <br /> , Electric heat installation in existing residence @$ <br /> SERVICES <br />__ Temporary Construction Service ........ ~ $ <br />__. Service change only in an existing residence @ $ <br /> Commercial or Industrial: <br />__ Service not over 100 amperes .... ~ $ <br />___ Service over 100 amperes bur not more than 200 amperes (als <br />Service over ~00 amperes but not more than 400 amperes @ $ <br />, Service over 400 amperes but not more than 600 amperes (~. $ <br />,__ Service over 600 amperes @ $ <br /> <br />.__ Not more than 100 amperes @$ <br /> <br />.... Over 200 amperes but not mo~ than 400 amperes @ $ <br />__ Over 400 amperes @ $ <br />__,_ Feeder over 600 volts <br /> <br />.... D Each electric sign or outline lighting @ $ <br />.... E Each swimming pool (bonding) (~ $ <br /> <br />...... On-Site Technical Review (apply directly at Marion County only) <br />__ Industrial Plant ~nspe¢lon (apply directly at Marion County only) <br />Reinspection Fee ¢' $ 20 00 <br /> FEE <br /> <br />50 O0 <br />75.00 <br />105 O0 <br />3000 <br /> <br /> 30.00 <br /> 3000 <br /> <br />45,00 <br />7000 <br />100 O0 <br />15000 <br />200 O0 <br />4~000 <br /> <br />g5,00 <br />4000 <br />70 00 <br />8500 <br />120,00 <br /> <br /> 2500 , ,-~ ~ <br /> 2500 <br /> 3000 <br /> 30 O0 <br /> 30,00 <br /> <br /> 20 O0 <br /> <br /> .... '2 <br /> <br /> Please return COMPLETE APPLICATION PLAN REVIEW FEE .~. <br /> INVESTIGATION FEE ~ / ~r' <br /> w~th the indrcated fee. FLEET SURCHARGE <br /> ~,~ . / ,~ TOTAL S ~.-~ ~, <br />SIGNATURE OF AP~'LICANT ~~¢~"/ _/ /~_~/~--,~''~ <br />[] HOMEOWNERS - I he~oy cert~e p~'operty described above, at which location I propose to make an electrical installation for <br /> my own use and this property is not being constructed for sale, lease or rent <br /> <br /> <br />