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Fle~d¥ ~o.r i~spe~tlon ~ ? <br /> <br /> MARION COUNTY <br />DEPT. OF BUILDING INSPECTION <br /> <br />Wi]~ call for inspection ? <br /> <br />ELECTRICAL PERMIT <br />220 High Street NE <br /> Salem, Oregon 97301 <br /> ph'- 588~147 <br /> <br />81de, Permit# <br />Elea Permit# <br /> <br />L!cense No Registration NO,, <br /> <br />Job AddressS <br /> <br />Owner/Builder <br /> <br />Electrical Firm:: <br /> <br />Superv~slng Electriclan~ <br /> <br />Phone .__~c~,~.~_~ ~ Address <br />Phone: Address; <br /> <br />Directions to Job ~. <br /> <br />No_ <br /> <br />__ Service over 400 amperes but not more than B00 amperes <br /> Service over 600 amperes ....................................................................... <br />__ Service over 600 volts ........................................................................... <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br /> Installation of Alterations ct Relocation of Distribution Feeders: <br />__ Not more than 100 amperes ................................................................... <br /> <br />__ Over 100 amperes but not more than 200 amperes ..................................... <br />__ Over 200 amperes but not more than 400 amperes ..................................... <br /> Over 400 amperes ................................................................................. <br /> <br />__ Feeder over 600 volts ............................................................................ <br /> MISCELLANEOUS <br /> A $10.00 Label shall apply for the following installations: <br /> I, Mobile Home Installation <br /> <br /> RESIDENTIAL <br />Residence wiring less than 1000 sq, f~ ...................................................... @ $ 15.00 <br />Residence wiring less than 2000 sq. ft ....................................................... @ $ 2B,00 <br />Residence wiring over 2000 sq,, f~ ............................................................. @ $ 35,00 <br />Electric heat installation in existing residence ............................................ @ $ 10.00 <br /> SERVICES <br />Temporary Construction Service ............................................................. @ $ 10.00 <br />Service change only in an existing resMence ............................................... @ $ 10.00 <br />Commercial or Industrial: <br />Service not over 100 amperes ................................................................. @ $ 15.00 <br />Service over 100 amperes but not more than 200 amperes ........................... @ $ 25,00 <br />Service over 200 amperes but not more than 400 amperes ........................... @ $ 35.00 <br /> @ $ 50.00 <br /> @ $ 65~00 <br /> @ $150.0o <br /> <br /> a. F. ach Mobile Homespace in park ..................................................... @ <br /> b. Each supply for Mobile Home (new or replacement) .......................... @ <br />__ 2, Each 'Farm building other than residence .............................................. @ <br /> <br />__ 3. Each irrigation pump ..................................................................... @ <br />__ 4. Each electric sign or outline lighting ................................................... @ <br />__ 5, Each residential swimming pool ....................................................... @ <br /> BRANCH CIRCUITS <br />__ One new circuit; alteration or extension ................................................... @ <br /> <br />$ 10.00 <br />$ 15,00 <br />$ 25.00 <br />$ 30.00 <br />$ 40.00 <br /> <br />$ 20.00 <br />$ 10.0o <br />$ 10.00 <br />$ 10.00 <br />$ 10.00 <br />$ 10,00 <br />$ 10.00 <br /> <br />$ 10.00 <br /> <br /> Amount Received <br />$ <br /> <br />,I0.00 <br /> <br />__ Two or more new circuits; alterations or extensions ................................... @ $ 15,00 <br /> SUBTOTAL $ qO.OQ, <br /> O~'7~ ADD STATUTORY SURCHARGE: 4% of Subtotal $ - <br /> TOTAL $ 10. ~l-O <br />I agree to make the electrical installation according to the submitted plans and specifications, the laws of the State of Oregon and the <br />Ordinances of Marion County. Permit expires if work not commenced within 120 days, <br /> <br />SIGNATURE OF APPLICANT: .... <br /> <br />[] HOMEOWNERS - I hereby certify that I am the owner of the property described above, at which location <br /> an electrical insta(lation for my own use and this property is not being constructed for sale, lease or rent. <br /> <br />SIGNATURE OF APPLICANT: ~'~"~J~//~'"" ' ~ <br /> <br />propose to make <br /> <br /> \ <br /> <br /> <br />