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MARION COUNTY BUILDING INSPECTION <br /> Senator BidS,, NO,, <br /> 22Q High Street NE <br /> Salem, Oregon 97301 <br /> <br /> Phone 588-5147 <br /> Code-A-Phone e::30 pM - 8:00 A.M, <br /> <br />Owner <br /> <br />Job Address <br /> <br />Electrician <br /> <br />ELECTRICAL PERMIT APPLICATION <br /> <br /> Phone Mailing Address <br /> <br /> Cross Street <br /> <br /> Phone <br /> <br />-Phone <br /> <br />Address <br /> <br />Address <br /> <br />Electrical Contractor's No <br /> <br />Home Builder's Registration NO <br /> <br />Supervising Oseef -~ Residential ~ ' New U Addition r~ Occupancy <br />Eleotec~an's No Building ] Commercial L~ Alteration [~ Relocation ~ Change <br /> <br /> No,, RESIDENTIAL <br /> ____ Residence wiring less than 1000 sq ft (e,$ <br /> .[_ Residence wiring less than 2000 eq ft (~ $ <br /> ._ Residence wiring over 2000 eq ft <br /> Electric heat installation in existing residence 8i) $ <br /> SERVICES <br /> Temporary Construction Service e~: $ <br />...... Service ohen§e only in an existing residence ih:. $ <br /> Commercial or Industrial: <br /> Service not over 100 amperes ('a~ $ <br />.... Service over 100 amperes but not mere than 200 amperes (~¢. $ <br />..... Service over 200 amperes but not more than 400 amperes, as $ <br /> Service ovor 400 amperes but not more than 600 amperes ih, $ <br />.... Ser,~iee over 600 amperes t~= $ <br />..... Servfce over 600 volts e~ $ <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br /> Installation of Alterations or Relocation of Distribution Feeders: <br /> . Netmorethan 100amperes <br /> Over 100 amperes but not more than 200 amperes <br /> Over 2OO amperes but eet mom than 4OO amperea <br />.... Over 400 amperes <br /> _.. Feeder over 600 volts <br /> MISCELLANEOUS <br />.... A Each trei~er or mobile home space (Service equipment) (¢¢ $ <br />__ B Eachsuppyform0bdehomefco ncc on <br />__. C EachirrigationpumpfettacharnapshocSnglocatisn) ('~f=$ <br />D Each electric sign or outline Iighting 8~ $ <br />E Each swimming poollbonding) (h $ <br /> BRANCH I~IRCUITS <br /> One new c~rcuit alteration or extenston e~ $ <br /> Two ar more new circuits alterations or extensions r,i~ $ <br /> Other fas per NEC and Building Officiall <br /> On-Site Technical Review {apply d~rectly at Marion County onlyl <br /> Industda~ Plent lnspec~ion apply directly et Mar~on County only) <br />.... Rmnspection Fee r¢~ $ <br /> <br /> 50 00 <br /> 75 00 . <br />10500 <br /> 30 00 <br /> <br />Please return COMPLETE APPLICATION <br />with the indicated fee <br /> <br />2000 <br />3000 __ <br /> <br />L.:I HOMEOWNERS - I hereby certify that I am the owner of he property described above, at which location propose to make an eec r ca inslallation fo <br /> <br /> a50o __ <br /> 70 O0 __ <br /> 10000 <br /> 15000 <br /> 200 00 <br /> 450 O0 _ <br /> <br /> id. $ 2500 <br /> e~' $ 4000 <br /> di' $ 70 O0 <br /> ,::u~$ 8500 ._ <br /> I:¢' $ 120 00 <br /> <br /> 2500 __ <br /> 25,00 <br /> 30 O0 <br /> 30 O0 <br /> 30 O0 __ <br /> <br /> 2000 <br /> 3000 __ <br /> <br /> 20 00 <br /> <br />STATE SURCHARGE .~, ~ ~' <br />PLAN REVIEW FEE <br />INVESTIGATION FEE <br />FLEET SURCHARGE ~ <br /> TOTAL $ ~_,~_.r _~ ~/~? <br /> <br /> <br />