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Received By __ <br />I~ate <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> Senator Bldg. NO. 225 <br /> <br />ELECTRICAL PERMIT APPLICATION <br /> <br />Phone' <br /> <br />Site No, ;: <br /> <br />Cross Street <br /> <br /> ,, Residential New [] Addition [] <br />Building Commercial [~ Alteration [] Relocation [] Change <br /> <br /> No, RESIDENTIAL <br /> __ Residence wiring lessthan 1000sq ft ...... @ $ 50,00 <br /> __ Resideecewir[nglessthan2000sq ft ~$ 75.00 <br /> -- Residencewlrlngover2000sq ft @$ 10500 <br /> ____ Electric heat installation in existing residence ~'d) $ 30 00 <br /> SERVICES <br /> __ Temporary Construction Service @ $ 30 00 <br /> -- Servicechangeon~yinanexlstlngresidence @$ 30,00 <br /> Commercial or Industrlah <br /> ..... Service not over 100 amperes @ $ 4500 __ <br /> __ Serviceoverl00amperesbutnotmorethan200amperes @$ 7000 <br /> -- Serviceover200amperesbutnotmorethan400amperes @S 10000 <br /> .... Service ever 400 amperes but not more than 600 amperes @ $ 15000 __ <br /> __ Service over 600 amperes @ $ 200,,00 <br /> ..... Service over 600 volts @$ 48000 <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br /> Installation of Alterations or Relocation of Distribution Feeders: <br /> __ Notmorethanl00amperes ..... @$ 2500 <br /> __.__ Over 100 amperes but not morethan 200 amperes ....... ~ $ 4000 __ <br /> __ Over200amperesbutnotmorethan400amperes @$ 70,00 <br /> __ Over400amperes ......... @$ 8500 <br /> __ Feederover600volts .......... @$ 120,00 <br /> MISCELLANEOUS <br /> A EaOhtrailerormobtlahomespace(Serviceequipment) ~$ 2500 <br /> __ S Each supply for mobile home (Connection) .... ~t~ $ 2500 <br /> __., C Eachirrigetionpump(Agacharnapshowinglocation) (~,$ g000 <br /> .... D EaCh electric sign or outline lighting ..... ~' $ 30,00 <br /> _.__ E Each swimming pool(bonding) @ $ 30 00 <br /> BRANCH CIRCUITS <br /> <br /> Two or more new circults, altsrstions or extensions @$ 3000 <br /> __ Other (as per NEC and Building Official) <br /> ---- On-Site Technical Review (apply directly at Madon County only) <br /> __ Industrial Plant Inspection (apply directly at Marion County only) <br /> __~ Reinspection Fee ~' $ <br /> <br /> STATE SURCHARGE /' ~' <br /> Please return COMPLETE APPLICATION PLAN REVIEW FEB __ <br /> with the indicated fee,, INVESTIGATION FEE <br /> FLEET SURCHARGETOTAL <br /> <br />HOMEOWNERS - I hereby cer~ity that I am the owner of the prop~y <br /> described above at which location I propose to make an electrical <br />my own use and this property is not being constructed for sale, lease or rent, <br /> <br />SIGNATURE OF APPLICANT <br /> <br />installation for <br /> <br /> <br />