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Received By <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br /> *. .. Senator Eildg. No 225 <br /> 220 High Street NE <br /> Salem, O~egon 97301 <br /> <br /> Phone 58a-5147 <br /> Code-A-Phone 4:a0 PM - 8:;00 A.M. <br /> <br />ELECTRICAL PERMIT APPLICATION <br /> <br /> Phone Mailing Address <br /> <br /> Site No Cross Street <br /> <br />Electrical Cor~treotor:s No <br /> <br />Phone <br /> <br />Phone:: <br /> <br /> Address <br /> <br />~dress <br /> <br />Home Builder's Registralion No <br /> <br />Eiectrtc~an's No uilding Commercial ~- Alteration <br /> <br />Addition [] Occupancy <br />Relocation b Change L_I <br /> <br /> No RESIDENTIAL <br /> Residence wiring less than 1000 sq ft <br /> "~-- Residence winng less than 2000 sq ft <br /> Residence wiring over 2000 sq ft <br /> .... Electric heat installation ~n e×ietin9 residence <br /> SERVICES <br /> TemporaryConstruction Serwce e $ 30 00 <br /> Service change onlyin an existing reeideace (?~ $ 30 00 __ <br /> Commercial or Industrial: <br /> (~' $ 45 00 <br /> Service not over 100 amperes <br />__ Service over 100 amperes but not morethan 200 amperes g,= $ 7000 __ <br /> Service over 200 amperes but not more than 400 amperes (b, $ 100 00 <br />___ Service over 400 amperes but not more than 600 amperes a,, $ 15000 __ <br />.... Service over 600 amperes (n $ 20000 <br /> Service over 600 volts ,~t, $ 45000 <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br /> Instabation of Alterations Or Relocation of Distribution Feeders: <br /> Not mom than 100 ~mperes <br /> Over 100 amperes but not more than 200 amperes <br /> O~er 200 amperes bdt not more than 400 ~mperes <br /> Over 400 amperes <br /> Feeder over 600 volts <br /> MISCELLANEOUS <br /> .... A Each trailer or mobile home space (Service equrpmenti <br /> ..... B Each supply' for mobile home (Connecten) <br /> <br /> D Each electric sign or outline lighting <br /> E Each swimmieg pool [bonding) <br /> BRANCH CIRCUITS <br />.... One new circuit: alteration ~r e×tens~on a~ $ 20 00 <br /> fwo or more new c~rcuits, alterations or extensions (~¢ $ 30 00 <br /> <br />~$ <br /> <br /> 5000 <br /> 75 00 <br />105 00 <br /> go 00 <br /> <br />(¢,: $ 25 00 <br />rt~' $ 40 00 <br />~ $ 70 00 __ <br /><¢~ $ 85 00 <br />(<~ $ 120 00 <br /> <br />('.$ <br /> <br /> <?, $ <br /> <br /> (i~ $ <br /> <br />2500 <br />2500 <br />30 00 <br />30 00 ........ <br />30 00 <br /> <br /> Other las pe~ NEC and Bu~ldm90ffictah <br />____ On-Site Technical Re'dew lapply directly at Marion County onlyl <br /> lndu~trial Plant Inspection ~ apply directly at Marion County only) <br /> Reinspection Fee <br /> <br />Please return COMPLETE APPLICATION <br />with the ~ndicated fee, <br /> <br />(¢ $ 20 00 <br />FEE <br />STATE SURCHARGE <br />PLAN REVIEW FEE <br />INVESTIGATION FEE <br />FLEET SURCHARGE ..... ~,~q,7 <br /> <br /> TOTAL . -$- ~.~-~'/~2 <br />lagreetamaketheelectrF0ali~stallar ac rdl~gtoti~es ttedpJ ~ specrfiCat~orl~ tholaw$oftheStateofOre§onandtheOrdrr/a~co~ofMadonOoum¥ <br /> · ,Job No: <br /> <br />I I HOMEOWNERS - I hereby certify that I am the owner of the property described above, at which location I propose to cqake an electrical installation for <br /> my own use and this propeCy is not bain9 constructed for sale lease or rent <br /> <br />SIGNATURE OF APPLICANT <br /> <br />MC 15-34 <br /> <br /> <br />