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Received By; cate,.__ MARION COUNTY BUILDING INSPECTION Senator Bldg. No. 225 Salem, Ol'egon 97301 Phone s88-$147 ELECTRICAL PERMIT APPLICATION Phone:' Mailing Address} /'~,// , / Site No.'. Cross Street: ' :lam Phone: Address: r+s No,: Home Builde'~ Registration NO,: Use~f Resid~'~tial ~ ' New ~ Addition ~ ........... Occupancy Building; Commemial ~ Alteration ~ Relocation ~ Change Supervising Electrician: Electrical Con Supervising No. RESIDENTIAL __ Rasidencewlrlnglessthanl000sg, ft ................................. @$ 50.00 ___~_ Res~dencewiring less than 2000 gq. ft ................................. @ $ 75.00 -- Rasidencewirlngover2000sq. ft .................................... @$ 105,00 __ Electric heat installation in existing residence ........................... ('&~ $ @0.00 SERVICES --- TemporaryConstructlonService ..................................... @ $ 30,00 __ Servicechange only in an existing residence ........................... @ $ 30.00 Commercial or Industrial: __ Servlcenotoverl00amperas ....................................... @$ 45.00 --, Serviceoverl00amperesbutnotmofethan20Oamperes ................. {-q~$ 70.00 ...... Service ever 200 amperes but not more than 400 amperes ................. @ $ 100,00 __ Service over 400 amperes but not more than 600 amperes ................. @ $ 150.00 Serviceover600amperas ......................................... ~$ 200.00 __ __ Service over 600 volts ............................................. @ $ 450 COMMERCIAL AND INDUSTRIAL FEEDERS Installation of Alterations or Relocation of Distribution Feeders: __.. Not mere than lO0 amperes ........................................ ~.}$ 25.00 __ Over 100 amperes but not more than 200 amperes ....................... @ $ 40.00 ____ Over 200 amperes but not mom than 400 amperes ....................... ~ $ 70.00 __ Over400amperes ............................................... @$ 88.00 ____ Feadarover6OOvolts ............................................. @ $ 120.0o MISCELLANEOUS A. Eashtrailerormobilehomespaee($ervlceequipment) .................. ~)$ 25.00 __ B. Each supply for mobile home (Connection) ........................... ~) $ 25.00 ~__ C. Eashirrigationpump(Anachamapshowinglocation) ..................... ElS 30,00 __ D. Each electric sign er outlinelighting ................................ £¢ $ 30.00 __ E. Each swimming pool (bonding) ................................... ¢/~ $ 30.00 BRANCH CIRCUITS -- One new circuit; alteration or extension ............................... (&~ $ 20,00 -- TwoormorenewclrCuits;alterationscrextenslons ....................... ~$ 30,00 .... Other (as per NEC and Building Offlsial) ......................................... -- On-Site Technical Review (apply directly at Marlcn County only) ...................... ___ Industrial Plant Inspection (apply dkestly at Marion County only) ...................... __ Reinspection Fee ................................................ ~_~ $ 20,00 FEE STATE SURCHARGE Please return COMPLETE APPLICATION PLAN REVIEW FEE with the indicated fee. INVESTIGATION FEE FLEETSURCHARGE r '" ~Y TOTAL ~ , t agree t° make the electrical instaflati°/°r./¢.~, t° the ~u.....;~t~'~2"P~ho. ati°ns' t he law~ °f the State °f Oreg°n and the ~r~'~an~'~'-s-f(b~r~°n l~°~tY' ~-~'~ .-- SIGNATURE OF AP PLICANT; ~ - [] HOMEOWNERS - I hereby certify that I am the owner of the property described above, at which location I propose to make an eleetrical installation for my own use and this property is not being constructed for sa~e, lease or rent. SIGNATURE OF APPLICANT;. MC 15-34 (owne¢ doing his own work)