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Received By <br />Cate <br /> <br />MARION COUNTY BUIL~IING INSPECTION <br /> Senat~or <br /> B~dg, No, ~2g <br /> 220 High Street NE <br /> Salem. Oregon 97301 <br /> <br /> Phone 588-5147 <br /> Code-A-I~hone 4:30 RM,, - 9:00 A,,M,, <br /> <br />ELECTRICAL PERMIT APPLICATION <br /> <br />Owner <br /> <br />Phone:: <br /> <br />Supervising Electrician <br /> <br />Electrical ContractoOs NO <br /> _.._~q ~ /,~ ~ ~ <br /> <br />Supervising Use of <br />Electrician's NO ~.~ ~3~-~ Building <br /> <br />Phone <br /> <br />Croes Street:: <br /> <br />Address <br /> <br />Address:: <br /> <br />Home Builder's Registration NO:: <br /> <br />Residential ~' New [] <br />Commercial ~] Alteration [] <br /> <br />Addition [] Occupancy <br />Relocation [] Change F3 <br /> <br /> No, RESIDENTIAL <br /> ____ Residence wiring lees than 1000 sq ft ..... (.q) $ 5000 <br /> Residence wiring lessthan 2000 eg ft (~ $ 75 00 <br /> __ Residencewiringover2000sq ft (.~ $ 10500 <br /> Electric heat installation in existing residence (~h $ 3000 <br /> SERVICES <br /> ___ Temporary Construction Service ...... ('~.:, $ 30 00 <br /> __ Servicechangeonlyinanexistingresidence ('dS 3000 <br /> Comme~clal or Industriah <br /> __ Service not over l00 emperes (~$ 4500 <br /> Service ever 100 amperes but not more than 200 amperes (iz'$ ?000 <br />__ Service over 200 amperes but not more than 400 amperes gz~ $ 100 00 <br /> Serviceover400amperesbutnotmorethen600amperes (i~=$ 15000 __ <br />__ Service over 600 amperes ('~i~ $ 20000 <br /> Service over 600 volts ~i'$ 45000 <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br /> Installation of Alterations or Relocation of Distribution Feeders: <br /> Not more than 100 amperes 0'$ 2500 <br />___ Over lOO amperes but not more than 2OO amperes (b$ 4000 <br />__ Over2OOamperesbutnotmorethan4OOamparee (~,$ '7000 __ <br />..... Over 400 amperes (~i~ $ 85,00 <br />__ Feeder over 600 volts (~, $ 120 O0 <br /> MISCELLANEOUS <br />...... A Eeehtrailerormobilehomespa~e6Sei~iceequipmenp (-d~$ 2500 <br />__ B Eachsupplyforrnobilehome(Oonnectiont (i~:$ 2500 <br />__ C Each irrigation pump {Attach a mapshowlngloCatlOn~ (<f' $ 30 00 <br /> D Each electricsignoroutlinelighting ~: $ g0 00 __ <br />__ E Eachswimming pOOl(bonding) ~' $ 3000 <br /> BRANCH CIRCUITS <br />__ Onenewcircui :a era on or extens~en {a~ $ 2000 <br />,/ ' Twoerrnorenewcircuits. alterationsorextenelons (~$ 30,,00 <br />.~ Other (as per NEC and Buildin9 Official) <br />__ On-Site Technical Review fapply directly at Manon Ooucty only) <br /> <br />__ industrial Plant Inspection (apply directly at Marion County only) <br />___ Reinsgection Fee <br /> <br />Please return COMPLETE APPLICATION <br />with the indicated fee. <br /> <br /> (b 5 g000 <br /> FEE <br />STATE SURCHARGE <br />PLAN REVIEW FEE <br />INVESTIGATION FEE <br />FLEET SURCHARGE <br /> <br /> I agree to make the electrical ins ordi the itteg pta nd o ations, the laws of the State of Oregon and the Ordinances of Marion Counly <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 /> my own use and this property is net being constructed for sale, lease or rent <br /> <br />81GNATURE OF APPLICANT ¢ <br /> <br /> <br />