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/7 / ..~ ~I%RION COUNTY BUILDING INSPECTION <br /> <br /> ~A~9~ ~%S?[~B~E~RICAL PERMIT APPLICATION <br />Owner: ~D ~' ~hone; Mai~ng Ad,ss; <br /> <br />Job A~dress; <br /> <br />E~rical Firm: <br />Supe~ising Electrician: <br /> <br />Site No.: Cross Street'. <br />Phone: Address: <br />Phone: Address: <br /> <br />Electrical Contrector~ NO.: <br /> <br />Home Builder~ Registration NO.: <br /> <br />Supervising <br />Electrician's No.: <br /> <br />No. <br /> <br />l <br /> <br /> Use of ~.J~[q/~ Residential New <br /> Building: ~/4~ Commemlal [] Alteration [] <br /> <br /> RESIDENTIAL <br />Residence wiring leas than 1000 sq, ff ................................. @ $ 50,00 <br />Residence wiring leas than 2000 sq, ft ................................. @ $ 75.00 <br />Residence wiring over 2000 sq, ft .................................... Cq~$ 105,00 <br />Electric heat installation in existing residence ........................... @ $ 30,00 <br /> SERVICES <br />Temporary Constru~ion Service ..................................... @7 $ 30.00 <br />Service change only in an existing residence ........................... @ $ 30.00 <br />Commemial or Industrial: <br />Service not over 100 amperes ....................................... {~ $ 45.00 <br />Service over 100 amperes but not more than 200 amperes ................. @ $ 70.00 <br />Service over 200 amperes but not more then 400 amperes ................. @$ 100,00 <br />Service over 400 amperes but not more than 600 amperes ................. (~ $ 15o.oo <br />Service oVer 600 amperes ......................................... @$ 200,00 <br />Service over 600 volts ............................................. @_ $ 450,00 <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br />Installation of Alteratlolle or Relocation of Distribution Feedere: <br />Not mom than 100amperes ........................................ @ $ 25.00 <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, Each trailer or mobile home space (Service equipment) .................. @ $ 25,00 <br />B. Each supply for mobile home (Connection) ........................... @ $ 25.00 <br />C, EechlrrJgationpump(Attacharnapshowinglocation) ..................... @$ 30,00 <br />D, Each electric sign or outlinelightlng ................................ @ $ 30,00 <br />E. Each swimming pool (bonding) ................................... @ $ 30.00 <br /> BRANCH CIRCUITS <br />One new circuit; alteration or extension ............................... @ $ 20.00 <br />Two or more new circuits; alterations or extensions ....................... @ $ 30,00 <br />Other (as per NEC and Building Official} ......................................... <br />On-Site Technical Review (apply directly at Marion Counfy only) ...................... <br />Industrial Plant Inspection (apply directly at Marion County octy) ...................... <br />ReinspectionFee ................................................ @ $ 20.00 <br /> FEE <br /> STATE SURCHARGE <br /> PLAN REVIEW FEE <br /> <br /> FLEET SURCHARGE <br /> TOTAL <br /> <br />Please return COMPLETE APPLICATION <br /> <br />with the indicated fee, <br /> <br />Addition [] <br />Relocation [] <br /> <br />Occupancy <br />Change [] <br /> <br />SlGN^TUREOFAPPLICAN~ Job No: <br /> <br />~/HOMEOWNERS - I hereby certify that I am the owner of the preperfy described above, at which location [ prop se to make an electrical Installation for <br /> ~roppse <br /> my own use and this property islet being constructed for sale, lease or rent, ~ ' {/~ <br /> <br />MC 15.34 ~ ' / ' (Owner d°ln9 his °wn w°r~) ~ ~-~'--- <br />Ro~ 12JS8 <br /> <br /> <br />