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 MARION COUNTY BUILDING INSPECTION <br />Received By; SenatOr B~clg. ,Ne. 2~ <br /> , 220 High Street NE <br /> <br />Date; <br /> Pl~one 588.5147 <br /> <br />ELECTRICAL PERMIT APPLICATION <br /> <br /> O~r: _ ' .... Phone: Mailing Address: <br /> Job Address: Site No.: C~ose Street: <br /> Supervlsln9 Electrblan: .... Phone; Address: <br /> <br />~ieciri~i contractor,s No.: Home Builder's Reglstj~tion NO.: <br /> Use of /~, ~ .... [~ _,~ New [~" Addition ¢"" Occupanc'~ <br /> Supervising S u ildin g .1~ #/~?/~.t~..t~ t Rosidential <br /> Commercial ~ I Alteration [] Relocation [] Change <br /> Electrician's No.: <br /> <br /> NO. RESIDENTIAL <br />__ Residence wiring lessthan 1000 sq, ft ................................. @ $ 50,00 <br /> Residence wiring over 2000 sq. ft ......... I'~J )' ,I.b, .11-tVl-'IF' tea.co <br /> <br /> SERVICES ~ , I ~ <br /> <br /> Service change only in an ex st ng res dance ....... [,,! i ! i, k, .~j., ~ 7J.,~.,,, @ $ 30,00 <br /> Commercial or Industrial: <br /> Service nct over l00 amperes .................. I'~R nM 'r"~llktT~/''' @$ 45,00 <br /> Service over 200 amperes but not more than 400 ~,~ . 'INSP'ECTION ~¢ <br /> LelNG too.aa <br /> <br />__ Serviceover6OOemperes ......................................... @ $ 200.00 <br /> Service over 600 volts ............................................. @ $ 480.00 <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br /> installation of Alterations or Relocation of Dietrlbutlon Feeders: <br />__ Not morethan 100 amperes ........................................ @ $ 25.00 <br />__ Over 100 amperes but not more than 200 amperes ....................... @ $ 40,00 <br />__ Over200amperesbutnotmorethan400ampares ....................... @$ 70.00 <br />~__ Over 400 amperes ............................................... @. $ 85,00 <br />__ FeederoverE00volts ............................................. @ $ 120,00 <br /> MISCELLANEOUS <br />..... A, Eachtrailerormobllahomespaca(Serviceequlprnent) .................. @$ 25,00 <br />__ B, Each suppJy for mobile home (Connection) ........................... @ $ gs.00 <br /> <br />__ C. Each irrigation pump(Attach ~ m8pshowinglocation) ..................... @ $ ~0.00 <br />__ D. Each electric sign or outlinelightlng ................................ @ $ 30,00 <br />...... E, Each swimming pool(bonding) ................................... @ $ 30,00 <br /> BRANCH CIRCUITS <br />...... One new olmutt;alteration or extension ............................... @ $ 20,00 <br />__ Twoormorenewcircuits;alterationsoraxteaslons ....................... .~$ 30,00 <br />.......... Other (as per NEC and Building Official) ......................................... <br />__ On.Site Technical Review (apply directly at Marlon County only) ...................... <br />__~ Iodustrlal Plant Inspection (apply directly at Marion County only) ...................... <br />__ Reinspection Fee ................................................ C&~ $ 20,00 <br /> FEE <br /> STATE SURCHARGE <br /> <br /> Please return COMPLETE APPLICATION PLAN REVIEW FEE <br /> <br /> with the indicated fee. ~' FLEET sURCHARGE <br /> TOTAL ~ <br />I agree to make the elect rical installation according to the 8ubrnitted pl~na and specificatiorls, the laws of the State of Oregon and the Ordinances of Marion County. <br /> Job No t <br />$1GNATUR,¢ O~ 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 property i~being constructed for sale, lease or rent. <br /> <br /> (Owner doing his own werk) <br />MC 15-34 <br />Rev, 1g/ag <br /> <br /> <br />