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Rece,v , ~' MARION COU I I~? INSPECTION <br /> · ed ey:w g. · <br /> <br /> ~BXL~ ' ELECTRICAL PERMIT APPLICATION <br /> <br />O--~ner: .................... tbhone: Mailing Address: <br />Job Address: site N0,J Cross Street: '~ '7 <br />Electrical Firm: Phone: Address: <br /> <br />Sup_ervislng Electrician; ' Phone; Address: <br /> <br />Electrical Contractor's No.; Home Builder's Registration NO.: <br />Supervising Use of ResidentJel [] New [] Addition [] Occupancy <br />Electrician's NO,; ~.'~,~q ,~ Building: Commercial ~] Alteration [] Relocation [] Change <br /> <br />NO, <br /> <br /> RESIDENTIAL <br /> Residence wiring less than 1000 sq. ft ................................. ~) $ 50.00 <br />__ Residence wiring lessthan 2000 sq. ft ................................. @ $ 75,00 <br /> Residence wiring ever 2000 sq, ft .................................... ~_~ $ 105.00 <br /> 30.00 <br /> <br />__ EIoctdchoatinstallatiooioexistingreeidence ........................... @ $ <br /> SERVICES <br />__ Temporary Construction Servlce ..................................... @ $ 50.00 <br />__ Service change only Jn an existing residence ........................... @ $ 30,00 <br />Com mo~.lal or Industrial: <br />__ Service notover 100amperes ....................................... @ $ 45,00 <br /> <br /> ___ Service over 100 amperes but not more than 200 amperes ................. @ $ 70.00 <br /> __ Serviceover200amperesbutnotmorethan400arnperes ................. @$ 100.00 <br /> __ Serviceover400amperesbutnotmorethanE00amperes ................. @$ 150.00 <br /> __ Serviceover600emperes ......................................... @ $ 200,00 <br /> __ Serviceover600volts ............................................. ~ $ 450.00 __ <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br /> Installation of Alterations or Relocation of Distribution Feeders: <br /> __ Not morethan 100amperes ........................................ @ $ 25,00 <br /> __ Over 100 amperes but not mom than 200 amperes ....................... @ $ 40.00 <br /> __ Over200amperesbutnotmorethan400amperes ....................... ¢~$ 70.00 <br /> __ Over400amperes ............................................... @ $ 85.00 <br /> __ Feederover600volts ............................................. @ $ 120,00 <br /> MISCELLANEOUS <br /> __ A, Eachtrailerormobilehomespace($ervJceequipmem) .................. @$ 25.00 <br /> __ B. Eachsupplyformobilehome(Conne~tlon) ........................... ~$ 25,00 <br /> __ C, Eachirrlgationpump(Attaehamapsl~owingl0cati0n) ..................... @$ 50.00 <br /> __ D. Each electric sign or outline lighting ................................ ~d~ $ 30.00 <br /> __ E, EaCh swimming pool(bonding) ................................... @ $ 30,00 <br /> BRANCH CIRCUITS <br /> ~ One new circuit; e~teratlon or extension ............................... @ $ 20.00 ~LO, O O <br /> __ Twoormorenewcircuits;alterationsorextensions ....................... @$ 30,00 <br /> __ Other (as per NEC and Bullding Offlclel) ......................................... <br /> __ On-Site Technical Revlew (apply dlrectly et Marion County only) ...................... <br /> __ Industrial Plant Inspection (apply directly at Madon County only) ...................... <br /> __ Reinspection Fee ................................................ ~ $ 20,00 <br /> FEE <br /> STATE SURCHARGE <br /> Please return COMPLETE APPLICATION PLAN REVIEW FEE <br /> with the indicated fee. INVESTIGATION FEE <br /> FLEET SURCHARGE <br /> / ~, ,,~ ,~ TOTAL $ ~ ~'. (~' ..... <br />$1GNATU R E OF APPLICANT: ;~itt ~ ~l~j~;ifi~ ,I ag roe to make the electrical installer' ~ng to th itted pi pe~ifioatlons, the laws of the State of Oregon and the Ordi nance~ Of~o~Marion ~o.C°unt~- <br /> <br /> HOMEOWNERS - ~ hereby certify that I em the ow.~f of the property described above, at which Iosetion I propose to make an electrical installation for <br /> <br />MC 15-S4 <br />Rev. l~/SS <br /> <br /> <br />