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Received By_ <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> Senator Bids,, No,, 225 <br /> 220 High Street NE <br /> ~ Salem, Oregon 97301 <br /> <br /> Phone 588-5147 <br /> Coao-A-Phone 4:30 PM. - 8~00 A.M <br /> <br />,lob Address <br /> <br />Electrical E'ii'~J ,/ <br />'Bugervi~[ng Electrician:: <br /> <br />ELECTRICAL PERMIT APPLICATION <br /> <br />Phone <br /> <br />Mailing Address:: <br /> <br />Cross Street:: <br />Addrass <br /> <br />Address <br /> <br />Electrical Contractors No <br /> <br />Home Builder's Registration No <br /> <br />Supervising Addition [] Occupancy <br />Ele0trician's No Relocation [~ Change LJ <br /> <br /> _ 'Use of Residential [] New [] <br /> Building Commercial [] Alterabon [] <br /> <br /> NO. RESIDENTIAL <br /> Residence wiring less than 1000 sq ft (b;~ <br />.... ~ Residence wiring less than 2000 sq ft ('_~t' <br /> Residence wiring ever 2000 sq ft ('d) <br /> Electric heat installation in existing reaidense ~i~ <br /> SERVICES <br /> Temporary Construction Service (~ <br /> .... Service change only in an existing residence <br /> Commercial or Industrial:: <br />__ Service not over 100 amperes <br /> Service over 100 amperes but not more than 200 amperes ~.s <br />.... Serwce ever 200 amperes but not more than 400 amperes (_~, <br />__ Service over 400 amperes but not more than 600 amperes (i~$ <br />__ Service over 600 amperes ((~ <br /> Service over 600 volts <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br /> Installation of Alteratlon~ or Relocation of Distribution Feeders: <br /> <br />___ Over 100 amperes but not more than 200 amperes a ~ <br />___ Over 200 amperes but not more than 400 amperes ((~$ <br />.... Over 4,00 amperes ('~ <br />.... Feeder over 600 volta <br /> MISCELLANEOUS <br /> <br />__ B Each supply for mobile home (Connoction) (??, <br />..... C Eachirrigahonpump(A achamapshowng cea on) ('ti' <br />D Each electric sign or outline lighting <br />E Each awimming pool (bonding) ('~ <br /> BRANCH CIRCUITS <br />__ One new circuit alteration or extension (~_i <br />__ Two or more new circuits, alterations or extenaions g~$ <br />Other las per NEC and Building Official} <br />--- On-Site Technical Review tapply directly at Marion C~uniy ~nly) <br /> <br /> 50 O0 <br /> <br />105 00 <br /> 30 O0 <br /> <br /> 30.00 <br /> 3000 <br /> <br /> 45.00 <br /> 7000 <br />100 O0 __ <br />150 00 <br />20000 <br />45000 <br /> <br /> 2500 <br /> 40 O0 <br /> 70 00 __ <br /> 85.00 <br />12000 __ <br /> <br /> 2500 <br /> 2~ 00 __ <br /> 30 00 ___ <br /> 30 00 <br /> 30 00 <br /> <br /> 2000 __ <br /> 30 O0 <br /> <br /> Industrial Plant Inspection (apply d~rectly at Marion County only) <br /> ___ Reinspection Fee ('~: $ 20 00 <br /> FEE <br /> STATE SURCHARGE <br /> Please return COMPLETE APPLICATION PLAN REVIEW FEE __ <br /> tNVESTIGATION FEE <br /> w~th the mdmated fee.. FLEET SURCHARGE <br /> · ¢ .4 ~ TOTAL $ <br /> <br /> I agruo to make the electno~)l )ostallahonco g to the Sub pla ec¢~cat~on$: the laws of tho State of Oregon and the Ordlnancos of Marion County <br /> SIGNATURE OF APPL CANT ....... <br /> <br />[] HOMEOWNERS - I hereby certify that I am the owner of the property described above= at which location I propose 1o make an electncal ~nstallation for <br /> my own use and this property is not being constructed for sale. lease or rent <br /> <br />SIGN^TUR~ OF APPLICANT <br /> <br /> <br />