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Received By <br /> <br />Pate. <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> ~, ~ Sol,stet BIAS,, NO,, 225 <br /> 220 High Street NE <br /> Salem, Oregon 97301 <br /> Phone S88-~147 <br /> Code-A-Phone 4::30 RM - 8::00 AM. <br /> <br />ELECTRICAL PERMIT APPLICATION <br /> <br />. Owner,,~ ~,~ <br /> Job Address <br /> <br /> Supervising <br /> <br /> ~le~iri~l-~%~-ractor S No <br /> <br /> Sspervising <br /> Electrician's No <br /> <br /> ~L/~/'"~ ',~¢ ~ Phone Mailing Address <br /> ~-~" , ..... ~ Cross Street <br /> <br />¢¢/~ ~ ';~O Phone Address:: <br /> <br />;trician Phone Address <br /> <br />rotors No Home Builder=s Registration NO <br /> Use of ............ ~%sidentiel --'-~ New '~-- .... Addition ~ Occupancy <br /> Building ....... Commera,a ~ A~teration ~ Relocation ~ Change <br /> <br /> No,, RESIDENTIAL <br /> Residence winng less than 1000 sq ft ~?~ $ 50,00 <br /> .~_~- Residerloe wiring less than 2000 sq ft ¢~, $ 7500 <br /> Residence wiring over 2000 sq ft g~' 3 105 00 <br /> Eloctnc heat installation gn existing residenoe (mS 3000 <br /> SERVICES <br /> ___ "li~mporaryConstruction Service (e $ 30 00 <br /> Service change only in an existing restdence ag 3 30 00 <br /> Commercial or Industrial:: <br />__. Servk~enotoverl00amperes (~$ 4500 <br /> .... Service over 100 amperes but not more than 200 amperes e~ $ 70 00 <br /> Service over 200 amperes bet hot more than 400 amperes ¢,' $ 10000 <br /> ..... Service over 400 amperes but not moro th~n 600 amperes (6 $ 150 00 <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 Distribution Feeders:; <br /> Not morothan t00amperes g~ $ 25 00 __ <br /> Over 100 arnperes but not more than 200 amperes g~$ 4000 <br /> Over 200 amperes but not more than 400 amperes ¢~, $ 70 00 __ <br /> ...... Over400arrlperes r~f~ 3 85 00 <br /> Feeder Over 600 volts e~ $ 120 00 <br /> MISCELLANEOUS <br />____ A EachtrailerormobJlohomespaoe ServioeeqL~lpr'qe S,,$ 2500 <br />B Each supply for mobde home IConneodon) ¢(d 3 <br /> <br />.... D Each eleelrS, sign or outline Ifghting (i¢~ $ <br />.... E Eachswimmingpool(bonding~ ¢~ $ <br /> BRANCH CIRCUITS <br /> ...... OrlerlewOir~.¢J =a era onorexenson (¢= $ 2000 <br />......... '1we or more newcircuits altershonsor extensions af$ 30 00 <br />... Other asperNECa~dBu dngOf ca) <br />..... On-Site Technical Review apply d red y at Mar on Coun y on y <br />.... IndtJstr,sl Plant Inspection I apply directly at Marion County only) <br />..... Re~nspection Fee <br /> <br /> g, $ 20 00 <br /> FEE <br />STATE SURCHARGE <br />PLAN REVIEW FEE <br />INVESTIGATION FEE <br />FLEET SURCHARGE <br /> <br />25 00 __ <br />30 00 <br />30 00 <br />30 00 .... <br /> <br /> Please return COMPLETE APPLICATION <br /> with the ind,¢ated fee ~_~ ~/~ <br /> <br /> HOMEOWNERS - I hereby certify tl~at I am ~he owner of the property described above, at which location I propose to make an electrmal i~¢tallation for <br /> my awn use and th~s proper~y ~s not being constructed for sale lease or rent <br /> <br />SIGN~TU RE OF APPLICANT <br /> <br /> <br />