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Recaived By <br />Date:: <br /> <br />MARION COUNTY BUILDING INSPECTION <br />~enetot Bid9, No. 22S <br />220 High street NE <br /> Salem, Oregon 97301 <br /> <br /> Phone $85-$147 <br /> Code-A-Phone 4:3a RM,, - 8:00 A,,M <br /> <br />Owne¢/ <br /> <br /> deb Address <br /> Electrical Firm <br /> <br /> Supervising Electrigen <br /> <br />¢~ ~,, z/z, 7,~,.~(r ELECTRICAL PERMIT APPLICATION <br /> <br /> Phone Mailing Address <br />$,/~, ) . Site NO,;; Cr~s Street:: .... <br /> ~ phone Address;; <br /> Phone:: Address:: <br /> <br />7- Home Builder~ Registration No <br /> 34604 <br /> Use of .............. Residential ~ New ~ ..... Addition ~ Occupancy <br />-S Building Commercial ~ Alteration ~ Relocation ~ Change <br /> <br />Electrical ContraCtor's No:: <br /> <br />Supervising <br />EleCtrician's No <br /> , __].r3 B 9--S <br /> <br /> NO. RESIDENTIAL <br /> ..... Residence wiring lessthan 1000 sq ft ........ (_-~ $ 5000 <br /> ___ Residence wiring lessthen 2000 sq ft (¢ $ 75 00 <br /> __. Residence wiring over 2000 sq ft ..... ~ $ 10500 <br /> Electric heat installation Jn existing residence (~ $ 30,00 <br /> SERVICED <br /> ___ Temporary Construction Service ~ $ 30 00 <br /> f" Service change only in an existing residence ...... (i:, $ 30,00 <br /> Commercial or Industrial; <br /> Service not over 100 amperes ...... r~f} $ 45 00 <br />__ Service over 100 amperes but not morethen 200 amperes ¢j:, $ 70 00 __ <br />..... Service over 200 amperes but not more then 400 amperes ~s$ 10000 <br />__ Serviceover400emperesbutnotmorethenC00amperes ~,$ 15000 <br />__ Service over 600 amperes ~) $ 200 00 <br />....... Service over 600 volts ....... (~ $ 450 00 <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br /> Installation of Alterations or Relocation of Dietrihution Feeders: <br />__, Not more then l00 amperes ~$ 2500 <br /> ___ Over 100 amperes but not more than 200 amperes ¢i$ 4000 <br />__ Over200amperesbetnotmorethan400amperes ~_~,$ 7000 <br /> Over 400 amperes ('d) $ 85 00 <br /> Feeder over600volts (~? $ 12000 <br /> MISCELLANEOUS <br /> A Each trailer or mobile home space (Service equipment) (~ $ 25 00 <br /> S Eachscpplyformobilehome(Conneclion) (-~,$ 2500 <br />-- C ~achirdgationpcmpt,~ttachamapshowingl~¢~tion) ~,$ <br /> .... D Eachelectricsignoroutlinelighting (r~'$ 3000 __ <br />__ E Eachswimmingpool(bonding) ¢,$ 3000 <br /> BRANCH CIRCUITS <br />__ One new circuit; alteration or extension , ~' $ 20 00 <br />__ Two or mere new circuits, alteretlons or extensions ¢' $ 3000 <br />____ Other (es per NEC and Building Official) <br />__ On-Site Technical Review (apply directly at Marion County only) <br />-- Industrial Plant Inspection (apply directly et Marion County only) <br />__ Reinspectlon Fee ~l' $ 2000 <br /> <br /> STATE SURCHARGE <br /> PLAN REVIEW FEE <br /> INVESTIGATION FEE <br /> <br />Please return COMPLETE APPLICATION <br />with the indicated fee,, <br /> <br /> FLEET SURCHARGE ~, TOTAL <br /> <br />I&greet~msketheelectdcalinstellat rdingtothesubmlttod lan~andspe 'iceti~nathelawsoftlleStateofOregon~ndtheOrdlnanoesofMarionOounty <br /> <br /> HOMEOWNERS ~ ] hereby certify that I em he owner of he property described above at which location I propose to make an electrical inetslletion for <br /> my own use and this property is not being constructed for sa e= lease 0¢¢-e nt <br /> <br /> <br />