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Received By', __ <br />Date: ~/~-~, ' <br /> <br />MARION COUNTY BUILDING INSPECTION <br />Senator Bldg. NO. 225 <br />220 High ~t~eet NE <br /> Salem, Ore,IOn 97301 <br /> <br /> Phone 588-S147 <br /> Code-A~Phone 4:30 P.M. - 85D A.M. <br /> <br />ELECTRICAL PERMIT APPLICATION <br /> <br /> ~ ~ Ph'one: Mailing Address; <br /> <br />~ 2ontractor~ No,: Home ~uilder~ Reglstratlee No,; <br /> <br /> )g Use of Residential ~ New ~ Addition ~ Occupancy <br /> t's No.: Building; Commercial ~ Alteration ~ Relocation ~ Change <br /> <br /> ~Jdress: <br /> <br />Supervisin! <br /> <br />Electrical Cont~ <br /> <br />Supervisin! <br />Electrician's <br /> <br /> No. RESIDENTIAL <br />____ Residence wiring lessthan 1000 sq. ft ................................. @ $ 50,00 <br />! Residence wiring less than 2000 sq, ft ................................. @ $ 75,00 <br />..... Residence wiring over 2000 sq, ft .................................... @$ 105.00 <br />__ Electric heat installation in existing residence ........................... @ $ 30.00 <br /> SERVICES <br />__ Temporary Construction Service ..................................... @ $ 30.00 <br />..... Service Change only in an existing residence ........................... @ $ 30.00 <br />Commercial or induetrial: <br />__ Servicenetovert00amperee ....................................... @$ 45.00 <br />__ Service over 100 amperes but not more than 200 amperes ................. ¢3 $ 70,00 <br />...... Service over 200 ampere5 but not more than 400 amperes ................. @ $ 100.00 <br />__ Service over 400 amperes but not more than 600 amperes ................. @ $ 150.00 <br />__ Servicecver600amperes ......................................... @ $ 200.00 <br />...... Serviceover600volts ............................................. @ $ 450.00 <br /> COMMERCIAL AND ~NDUSTRIAL FEEDERS <br /> Installation of Alterations or Relocation of Distribution Feeders: <br /> .. Notmorethanl00amperes ........................................ (tbs 25.00 <br />__ Over 100 amperes but not more 1hen 200 amperes ....................... ~ $ 40.00 <br />Over 200 amperes but not more than 400 areperes ....................... (i) $ 70.00 <br />__ Over 400 amperes ............................................... ~.~) $ 85.00 <br />Feeder over 600 volts ............................................. @$ 120.00 <br /> MISCELLANEOUS <br />....... A. Eachtrailerormobiiehomespaee(Servlceequipmeng .................. @$ 25.00 <br />-- lB. Each supply for mobile b4~me <br />__ C. Eachlrrigationpump(Attachamapshowingiocatlon) ..................... ((~$ $0.00 <br />..... D. EaCh electric sign or outlinelighting ................................ @ $ g0.00 <br />___ E. Each swimmingpool(bonding) ................................... ~ $ 80.00 <br /> BRANCH CIRCUITS <br />One new circuit; alteration or extension ............................... ~i~ $ 20.00 <br />..... Two or more new clreWts; alterations or extensions ....................... @ $ 30.00 <br /> <br /> __ Other (as per NEC and Buildlng 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 __ <br /> STATE SURCHARGE <br /> Please return COMPLETE APPLICATION PLAN REVIEW FEE <br /> - . . NVESTIGATION FEE <br /> w~th the ~ndmated fee. FLEETSURCHARGE ~,,¢' Y" <br /> TOTAL I $ ,¢-¢L ~ <br /> <br />I agree tO ma l(o the elect ri OW Inet ali ahoy/& c ~/¢r~ In, t ~d ~r'~.~.p .¢ification $, the laws of the State of D re~on and the Oral in,noes of Marion Count, <br />81GNATUREOFAPPLICANT:~//~/' ~-"'~ ~¢"'~"¢~ ~"~~ ~O~ ~O: <br /> HOMEOWNERS - I hereby certify that I am the owner of the properly described above, at which location I propose to make An electrical installation for <br /> <br />SIGNATURE OF APPLICANT:. <br /> <br />MC 15-34 (Owner doing his own week) <br />Rev, 12/88 <br /> <br /> <br />