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Received By: <br /> <br />MARION COUNTY BUILDINGI'NSPECTION <br /> Senator Bldg, <br /> 220 High Street NE <br /> Salem, Oregon 97301 <br /> <br /> Phone 588-$147 <br /> Code-A-Phone 4:3e P.M. <br /> <br />ELECTRICAL PERMIT APPLICATION <br /> <br />Owner:_~ ~.,.,,, "~0 ~-~ ,~/t./ Phone: Mailing Address; <br /> <br />Job Address: ~ / /'/~ "' ~ ,'""~'" Site No,: Cross Street: <br />%S;/,.- ~ .................. <br />Phone: Address: <br /> <br />Supervising Elemriclan: Phone: Address; <br /> <br />Electrical Contractor's No.: Home Builder's Registration NO.: <br />Supervising Uae of Residential [] New [] Addition [] Occu'p=~ncy <br />Electrician's No.: Su~lding; Commercial [] Alteration [] Relocation [] Change [] <br /> <br />No. <br /> <br /> RESIDENTIAL <br />__ Resldencewiring lessthan 1000 sq, ft ................................. @ $ 50,00 <br /> Residence wiring less than 2000 sq. ft ................................. @$ 75.00 <br />__ Resldencewiringover2000eq, ft .................................... @$ 105.00 <br />__ Electric heat installation in existing residence ........................... @ $ 30.00 <br /> SERVICES <br />__ Temporary Construction Service ..................................... @ $ 30.00 <br />__ Servicechange oniyin an exJetlng residence ........................... @ $ 30,00 <br /> Commercial or Industrial: <br />__ Service not over 100 amperes ....................................... @ $ 45.00 <br />__ Serviceoverl00amperesbutnotmorethan200amperes ................. ~$ 70,00 <br />__ Serviceover200ernperesbutnctmorethan400ampere$ ................. @$ 100.00 <br />__ Service over 400 amperes but not more than 600 amperes ................. @ $ 150.00 <br />___ Service over 600 amperes ......................................... @ $ 200,00 __ <br />__ Serviceover600volts ............................................. @ $ 450.00 <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br />Installation of Alterations or Relocation of Dietribution Feeders: <br />__ Nctrnorethanl00amperes ........................................ @$ 23.00 <br />__ Over 100 amperes but not more than 200 amperes ....................... @ $ 40.00 <br />__ Over 200 amperes but not more than 400 amperes ....................... @ $ 70.00 <br />Over400amperes ............................................... @ $ 85,00 <br />__ Feederover600volts ............................................. @$ 120.00 <br /> MISCELLANEOUS <br />__ A. EaehtraiJerormobiJehomespace(Serviceequipment) .................. @$ 25.00 <br />__ [3, Each supply for mobile home (ConrlectiDn) ........................... @ $ 25.00 <br />__.. C, EaohirrJgationpump(Attachamapshowlnglocation) ..................... @$ 30,00 <br />,___ D, Eachelectricsignoroutllnelighting ................................ @$ 30.00 <br />__ E. Each swJmming pool (bonding) ................................... @ $ 30,00 <br /> BRANCH CIRCUITS <br />.-- OcenewcircuJt;alteratJonorexteeslon ............................... @$ 20,00 <br />__ Twoormorenewc'scclt$;alterationsorextensions ....................... C~$ 80,00 <br />__ Other (as per NEC and Building Official) ......................................... <br />---- On-Site Techeicel Review (apply directly at Marion County only) ...................... <br />__ Industrlal Plant Inspectlon (apply directly at Marion County only) ...................... <br />__ Reinspection Fee ................................................ @ $ 20.00 <br /> FEE <br /> STATE SURCHARGE <br /> <br /> Please return COMPLETE APPLICATION PLAN REVIEW FEE <br /> ' ' ' INVESTIGATION FEE <br /> w~th the md~cated fee, FLEET SURCHARGE <br /> /~ TOTAL "$ ,-~,'~ ~"'~ , <br /> /I /1 ~ ,// /"l O -~ , ° / .... <br /> <br />[] HOMEOWNERS - I hereby certify that I am the owner of the property described above, at which location I prop~e to make an electrical installation for <br /> my own use and thie property is not being constructed for sale, lease or rent <br /> <br />SIGNATURE OF APPLICANT;__ <br /> <br /> <br />