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MARION COUNTY BUILDING INSPECTION <br /> <br /> 220 High Street NE <br /> Salem, Oregon 97301 <br /> <br /> Code.A.Phone 4:so P.M, - 8:80 A.M, <br /> <br />ELECTRICAL PERMIT APPLICATION <br /> <br />0,,,~ r: ," Phone: Malting Add. ss'. <br />Job Address: Site No,: .(_;.~,s s Street: <br />~upervi~ng ~le~trici~', ' ,, Phone: Address: ....... <br /> <br /> El~'~tric8l Contra~or~ NO.; ....... Home Builder~ Registration NO,: ~ <br /> Supervising Use of ~ ~ Residential ~' New ~ ' Addition ~ Occ~'pancy <br /> ~temtio~ ~ Change ~ <br /> ~ec~icJan~ No,: BuJldlng: ~ ~ ~ Cammerci~ ~ Relocation ~ <br /> <br />Please return COMPLETE APPLICATION <br />with the indicated fee, <br /> <br /> No. RESIDENTIAL <br />__ Residence wiring less than 1000 sq, ft ............ , .................... @ $ 50,00 <br />__ Rea~dencewidnglesathan2000sq. tt ...... . ........................... ~)$ 75.00 <br />__ Residence wiring over 2000 ag, ft .................................... C~__ $ 105,00 <br />.... Electric heat installation in existing residence ........................... ¢¢ $ 30.00 <br /> , SERVICES <br />__ Temporary Construmlen Service ..................................... C'~ $ 80.00 <br />__ ServicechangeenlyinanexJstingmsldence ~ .......................... @$ 30.00 <br /> Commercial or Industrial: <br /> Service not over 100 amperes ....................................... ~_~ $ 45.00 <br /> Service over 100 amperes but not more than 200 amperes ................. L~ $ 70.00 <br />____ Serv(ceover200amgeresbutnotmorethar~40Oamperes ................. ~ $ 100,00 <br />__ Serviceover400emperesbutnotmerethan600amperes ................. @ $ 150.00 <br /> Serviceever 600 amperes ......................................... @ $ 200.00 <br />___ Serviceover600volts ............................................. ~ $ 450,00 <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br /> Inetallatlon of Alteraflone or Relocation of Distribution Feeders: <br />__ Not morethan 100amperes ........................................ ~ $ 25,00 <br />__ Over 100 amperes but net more than 200 amperes ....................... ~) $ 40,00 <br />__ Over 200 amperes but not more than 400 amperes ....................... ~'~ $ 70.00 <br />__ Over400amperes ............................................... ~$ 85,00 <br />__ Feederover600volts ............................................. C~>$ 120,00 <br /> MISCELLANEOUS <br />__ A. Eachtrailerormobilehemespace($erviceesulpmenf) .................. ~)$ 25,00 <br />__ B, Each supply for mobile home(Connection) ........................... ~./$ 25,00 <br /> __ C, Each ITtlgat~on pump (Attach ;~ map snowi~g location) ..................... (.~ $ ~0.00 <br />__ D. Eechelectricsignoroutlinelighting ................................ @$ 30.00 <br />__ E, Each swimming pool (Pending) ................................... ~? $ 30.00 <br /> BRANCH CIRCUITS <br />./ ~ Onenewcimuit;alteretionorextension ............................... ~$ 20,00 <br />__ Two or more new circuits; alterations or extensions ....................... C~~ $ 30.00 <br />__ Other (as par NEC and Building Official) ......................................... <br />__ On. SlteTechnicalReview(applydirectlyatMarlenCountyonly) ...................... <br />__ Industrial Plant Inspecti0n (apply directly at Marion County only) ...................... <br />__ Reinspect~or~ Fee ................................................ ~ $ 20,00 <br /> FEE <br /> STATE SURCHARGE <br /> ~'~ PLAN REVIEW FEE <br /> FLEET SURCHA~{GE <br /> TOTAL <br /> <br /> agree to make the electrical installation according to the submitted plans and specifications, the laws of the State of Oregon and the OrdJnar~ces of Mertos County. <br /> <br />SIGNATUREOFAPPLICANT: ~0~ ~O: <br /> <br />[~'R/OMEOWNERS - I hereby certify that I am the owner of lhe property described above, at w~ch location I propose to make an electrical installation for <br /> my own use ¢~nd this property is not being constructed for sale, lease or rent, <br /> <br />MC 15-34 u ~ <br />Rev. 12/88 <br /> <br /> <br />