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Received <br />rJate; <br /> <br />MARION COUNTY I?~IILDING INSPECTION <br /> enator Bldg. NO. 225 <br /> 220 High Street NE <br /> Selem~ Oregon g7e01 <br /> <br /> Phone 588-5147 <br /> Code-A-Phone 4:30 P.M. - 8:00 A.M. <br /> <br />ELECTRICAL PERMIT APPLICATION <br /> <br />Owner; Phone: Mailing Address: <br />Job Address: Site No,: Cross Street: <br />Electrical Firm; Phone: Address: <br />,4~.O_~W_~L6CTFel£, 1/I/£. ~7o-¢278 1606 Oa/~ 5.4. 5.~. <br />Supervising Electrician: Phone: Address: <br />~LeA~d F. &vczn~ Srxme ~ <br />Electrical Contractor's NO,: Home Builder's Registration No.: <br /> <br />Supervising '-U~ ............................ Residential [] New [] Addition [] Occupancy <br />Alteration [] Relocation [] Change <br />Electrician'sNo2j27_~ .......... ~ Su deg: Commercial ,~ [] <br /> <br /> No. RESIDENTIAl <br /> ____ Residence wiring lessthan 1000 sq. ft ................................. @ $ 80,00 <br /> __ Residence wiring lessthan 2000 sq, ft ................................. @ $ 75.00 <br /> Residence wiring over 2000 sq, ft .................................... Cc¢$ 105,00 <br /> __ Electric heat installation in existing residence ........................... @ $ 30,00 <br /> SERVICES <br /> __ Temporary Construction Service ..................................... @ $ 30.00 <br /> __ Service change onlyin an existing residence ........................... @ $ gO.O0 <br /> Commercial or industrial: <br /> Service not over 100 amperes ....................................... ~) $ 45,00 <br /> ,! Service over 100 amperes but not more than 200 amperes ................. @ $ 70,00 <br /> __ Service over 200 amperes but not mom than 400 amperes ................. @ $ 100.00 __ <br /> __ Service over 400 amperes but not more than 600 amperes ................. ~; $ 150.00 <br /> __ Serviceover600amperes ......................................... @ $ 200,00 <br /> ServiceoverC00volts ............................................. @ $ 450.00 <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br /> Installation of Alterations or Relocation of Distribution Feeders: <br /> __ Not morethan 100 amperes ........................................ O? $ 25,00 __ <br /> __ Over 100 amperes but not more than 200 amperes ....................... @ $ 40,00 <br /> ........ Over 200 amperes but nolmore than 400 amperes ....................... @ $ 70.00 <br /> __ Over400amperes ............................................... ~'7~$ 85.00 <br /> _.__ FeederovsrC00valts ............................................. @ $ 120.00 <br /> MISCELLANEOUS <br /> __ A. Each trailer or mobile home space (Service equipment) .................. @ $ 25,00 <br /> B. Each supply for mobile home {Connection) ........................... ~) $ <br /> __ O, Each irrigation pump (Attach ~ map showinglocation) ..................... @ $ 30.00 <br /> __ D, Each electric sign Or outilne lighting ................................ (~3 $ 30.00 <br /> ___ E, Eachswimmlngpool(bonding) ................................... (~$ 30.00 <br /> BRANCH CIRCUITS <br /> ____ One new circuit; alteration or extension ............................... (A~ $ 20,00 <br /> --~ Twoormorenewcimulte;alterationsorextensions ....................... ~,$ 30.00 <br /> .......... Other (as per NEC and Building Official) ......................................... <br /> -- On-Site Technical Review (apply directly at Marion County only) ...................... <br /> ........... Industrial Plant Inspection (apply directly at Marion County only) ...................... <br /> __ Reinspection Fee ................................................ ¢~~ $ 20.00 <br /> FEE /4, o, 042 <br /> STATE SURCHARGE <br /> Please return COMPLETE APPLICATION PLAN REVIEW FEE <br /> with th'~ in'4i'~*'~'~ ~"- INVESTIGATION FEE ........... <br /> ~ ,.,,~t~u ~=~. FLEETSURCHARGE <br /> ~ __ /~ ¢¢' ~ TOTAL $ <br /> <br />lagreetomaketheelectricalinsta ordin t thee ttodpl ~pecifi tions, thelawsoftheStateofOregonandtheOrdlnanoesofMarionOour~ty, <br /> <br /> ~ / (S upe r vl~g sleclrlciact <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 not being constructed for sale, leaee or rent. <br /> <br />SIGNATURE OF APPLICANT: <br /> <br /> <br />