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. /] /' ,, ,~ ,~: ~ )UNTY BUILDING INSPECTION <br />Received By ~~ · ~' senator Bldg. NO,, 225 <br /> ,-' ,, 220 High Street NE <br /> <br /> %'~. " ELECTRICAL PERMIT APPLICATION <br /> <br /> Owneb.~ ~ ' Phon~il ........... Ma' 'ng Ad mss <br /> Job ~ddress; Y Site No,;: Cross Street~ <br /> Ele~ Phone:: Address:: <br /> Supervising Electrician Phone;; Address;; <br /> <br /> Electrical Comractor~ No '" Home Builde~ Registration No <br /> <br /> Supe~v~'~g .......................... ~" Use ef ~ / Residential ~¢ New ~ Addition B Occupancy <br />~,,~,,,¢,~,~,o / Bulldlng::~. Commercial U,J Alteration~ Relocation, ..... ~ Change <br /> <br /> NO. RESIDENTIAL <br />........ Residence wiring less than 1000 sq. ft ....... @ $ 50.00 <br />.... Residence wiring lessthan 2000 sq ft @ $ 7500 <br />__ Residence wiring over 2000 sq ft @ $ 10500 <br />__ Electric heat installation in existing residence ('a~ $ 30 00 <br /> SERVICES <br /> / Temporary Construction Service .............. (E¢$ 3000 <br />__ Service change onlyin an existing ~esJdence ..... @ $ 30 00 <br /> Commercial or Industrial: <br />...... Service not over 100 amperes .......... @ $ 45 00 <br />__ Servlcaeverl00amperesbutnotmorethan200amperes @$ 7000 <br />__ Serviceover200amperesbutaotmorethan400amperes ....... @ $ 100 00 <br />__ Service over 400 amperes but not more than 600 amperes ¢¢ $ 150 00 <br />Service over 600 amperes ......... ~' $ 20000 <br />__. Servceover6o0vol s .............. @ $ 450 <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br /> Installation of Alterations or Relocation of Distribution Feeders: <br />....... Not more than 100 amperes ....... ~:, $ 2500 <br />__ Over l00 amperes but not more than 200 ampe~ea @$ 4000 <br />__ Over 200 amperes but not more than 400 amperes @ $ 70 00 <br />__ Over400amperes ...... @ $ 85.00 <br />__ Feederover600volts @$ 12000 <br /> MISCELLANEOUS <br />A Each trailer or mobile home space (Service equipment) (~ $ ~500 <br />__ B Each supply for mobile home fConnection) @ $ 25 00 <br />.......... C Each irrigatior~ pump (Attach a rnap showing location) ......... @$ 3000 <br />__ D Eechelectricsignoroutlinelighting (-d)$ 30.00 <br />__~_ E Eachswimmingpooi(bonding) ......... ~*$ 3000 <br /> BRANCH CIRCUITS <br />.......... Onenewcircuit;alterationorextension ...... @ $ ~000 <br />__ Twoor more new circuits alterationsor extensions ~' $ 30.00 <br />....... Other (as per NEC and Building Official) <br />__ On-Site Technical Review (apply directly at Marion County only) <br />............ Industrial Plant Inspection (apply directly at Marion County only) <br />__ Reinspection Fee ('4' $ 20 00 <br /> FEE <br /> STATE SURCHARGE <br />Please return COMPLETE APPLICATION PLAN REVIEW FEE <br />with the indicated fee. FLEET SURCHARGE <br /> TOTAL <br /> <br /> Job No .* <br />SIGNATURE dE APPLICANT . ........... <br /> <br />[] HOMEOWNERS - I hereby certify that I am the owner of the property described above, at which location I propose to make an electrical installation for <br /> my own use and this propert~Cot being _od. pst ruoted for sale:, lease or rent. <br />SIGNATURE OFAPPUCANT _.~/~- ~-~ ~ , <br />Rev t3/88 <br /> <br /> <br />