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Received By; <br />Bate: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> Senator Bias. NO. 225 <br /> 220 HI,th Street NE <br /> SalSm~ Oregon 97301 <br /> <br /> ELECTRICAL PERMIT AppliCATION <br />Owner~~,~~'~'~ ~ii:i ~iii%~ideless; <br /> <br />Electrical Firm <br /> <br />Supervi~____-CEre~ <br /> <br />Electrical Cogractor~ No,; <br /> <br />Supervising -~, ~,,~ Useaf <br /> <br />Phone: A~ <br />Phone: Address; <br /> <br />Home Builder's Registration NO,; <br /> <br />zoo <br />Residential [] New <br />Commercial ~ Alteration <br /> <br />Addition <br />P, etocetlon <br /> <br />Occupancy <br />Change [] <br /> <br /> No, RESIDENTIAl. <br />.... Re¢idenee wiring less than 1000 sq. ft ................................. <br /> Residence wiring less than 2000 sq. ft ................................. <br /> .... Residence wiring over 2000 ed. pt .................................... <br />..... EJectdc heat installation Ic existing residence ........................... <br /> SERVICES <br /> _ Temporary Construction Service ..................................... <br /> Service change only tn an existing residence ........................... <br /> Commercial or Industrial: <br /> Service not over 100 amperes ....................................... <br /> Service over 100 amperes but oct more than 200 amperes ................. <br /> Service over 200 amperes 0ut not more than 400 amperes ................. <br /> <br /> · Service over 400 amperes but not mere than 600 amperes ................. <br />..... Service over 600 amperes ......................................... <br />..... Service over 600 volts ............................................. <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br /> Installation of Alterations or Relocation of Distribution Feeders: <br /> Not more than 100 amperes ........................................ <br />..... Over 100 amperes but not more than 200 amperes ....................... <br /> Over 200 amperes but not more than 400 amperes ....................... <br /> ~,. Over 400 amperes ............................................... <br />...... Feeder over 600 volts ............................................. <br /> MISCELLANEOUS <br />...... A. Eachtrailarormobilehomespaae($erviceequipment) .................. <br /> B. Each supply for mobile home (Connection) ........................... <br /> C. Each irrigatioc pump (Aaegh a map showing location) ..................... <br /> B. Each electric sign ar outline lighting ................................ <br /> E. Each swimming pool (bonding) ................................... <br /> BRANCH CIRCUITS <br /> Or~e new circuit; Biter atica Or exte~siOr~ ............................... <br /> <br />50.00 <br />78.00 <br />105,00 <br />30,00 <br /> <br /> 30.00 <br /> 30.00 <br /> <br />45.00 <br />70,00 <br />t00,00 <br />150.00 <br />200.00 <br />480.00 <br /> <br />25.00 <br />40,00 <br />70.00 <br />85.00 <br />120,00 <br /> <br /> 25.00 <br /> 25,00 <br /> 30.00 <br /> 30,00 <br /> ~0,00 <br /> <br /> 20,00 <br /> <br /> Two or more new circuits; alteratlons or extenslons ....................... (~$ 30,00 <br /> Other (as per NEC end Building Official) ......................................... <br /> ... On-Site Technlcal Review (apply directly at Marion County only) <br /> ...... Industrial Plant Inspectlon {apply directly at Marlon County only) ...................... <br /> ReinspecIion Fee ................................................ @ $ 20,00 <br /> FEE <br /> STATE SURCHARGE <br /> Please return COMPLETE APPLICATION PLAN REVIEW FEE <br /> . . . iNVEST CATION FEE <br /> wtth the mdmated fee. ~ ~. FLEET SURCHARGE <br /> ~ ) .¢ TOTALS __ <br /> <br />SIGNATUREOFAPPLICANT:j~¢'"'~ ~ ~.. - ~ ~ .... ~TO~ ~'0; <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 is not being constructed for safe, lease or real. <br /> <br />81GNATURE OF APPLICANT; <br /> <br /> <br />