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Received By __ <br /> <br />MARION COUNTY BUILDING INSPECTION <br />Sen~or Sldg. No. ¢,~g <br />220 High Street NE <br /> Salem, Oregon 97301 <br /> <br /> Phone 588-s147 <br /> Code-A.Phone 4::ac RM,, - 8::00 A.M <br /> <br />ELECTRICAL PERMIT APPLICATION <br /> <br />~C 7(~"~(~Ph°ne;: MailingAddreee:: <br /> <br />~ F'rm , Phone "" Address <br /> <br />~ E~ctr,~// Phone:: Address <br /> <br />~ng U~e of Residential ~ New ~ Addition ~ O~upanc~ <br />an~ NO Build~ng:; Commercial ~ AlteratiOn ~ Relocation ~ Change <br /> <br />Job Address <br /> <br />Supervising <br />Electrician's N~ <br /> <br /> No. RESIDENTIAL <br />__ Residence wiring leeethan 1000 sdft @ $ 5000 <br />~ Reeidence wiring less than 2000 sq ft ............. @ $ 75.00 <br />__ Residencewiringover2000eq ft @ $ 105 00 <br />.......... Electric heat inetallation in existing residence ....... @ $ 30 00 <br /> SERVICES <br />......... Temporary Conetrection Service .............. @$ 3000 <br />__ Service change only in an exieting reeidence ~ $ 3000 <br /> Commercial or Industrial: <br />..... Service not ever 100 amperee ....................... @ $ 45.00 <br />__ Service over 100 amperes but not more than 200 amperes @ $ 70.00 <br /> . Service over 200 amperee but not more than 400 amperee ..... @ $ 100 00 <br />__ Serviceover400amperesbutnotmorethanE00amperes @$ 150.00 <br /> Service over 600 amperes @ $ 20000 <br />.... Service over 600 volts ..................... @$ 450.00 <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br />leatallation of Alterations or Relocation of Distribution Feeders: <br />__ Not morethan 100amperes @ $ 2500 <br />..... Over 100 amperes but not more than 200 amperee @ $ 4000 <br />__ Over200amperesbutnotmorethan400amperes ............. @$ 70.00 <br />__ Over400amperes @ $ 8500 <br />.... Feeder over 600 volta ~'$ 1"000 <br /> MISCELLANEOUS <br /> A Each trailer or mobile home apace ($erv,ce equipment) (¢u$ 25.00 <br />__ 8 Each supply for mobile home(Connection) ..... (',e $ 25.00 <br />........... C Each irrigation pump (Attach a map showing I~cation) @ $ .30 00 <br />__ D Eachelectricsignoroutlinelighting ..................... (,=~$ 30.00 <br />............ E Each swimming pool (bonding) @$ <br /> BRANCH CIRCUITS <br />............ One new circuit; alteration or exteneion .... @ $ 20.00 <br />__ Two or more newoircuits; alterations or extensions ~ $ 8000 <br />__ Other (as per NEC and Building Official) <br />............. On-Site Technical Review (apply directly at Marion County only) ...... <br />___ Industrial Plant Inspectlon (apply directly at Marion County only) <br />__ Reinspection Fee ((7 $ 20 O0 <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 /> <br /> Job No. <br />SIGNATURE OF APPLICANT <br /> <br />~ HOMEOWNERS - I hereby certify that I am the owner of the property deecribed above: at which location I propose to mal<e an electrical installation for <br /> my own use and this property is not being constructed for sale: lease or rent. <br /> <br />SIGNATURE OF APPLICANT <br /> <br />MC 15,34 (O~ner deles his o~n work} <br />Rev 12~88 <br /> <br /> <br />