Laserfiche WebLink
ELECTRICAL PERMIT APPMCAllON <br /> Please c~rnptete a/I S~lions, 1through5 <br /> <br />1. LOCATION OF INSTALLA'nON <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br /> Salem, Oregon 97301 <br /> <br /> P~ne 588-5147 8,1x) a.m, - 4~0 pm. <br /> ~Phone: 588-7904 <br /> IIII FAX: 588-7948 Dale: <br /> I <br /> issued by: <br /> <br />Superv sot'$ L mns~o, ~ ph~Om ~ / <br /> <br />26. FOR OWNER I~TALkA'ROHS <br />Maiilng HJdrass <br /> <br />Phone <br /> <br />¢lty/stata/Zip <br /> <br />The Installation Js being made on property I own which is not Intended for sale, <br />lease or rent. <br /> <br />Check appropria~ imm and en~r Fee in ~e~on SB. <br /> <br /> ., Connected Imad over 200 amps (except single family dwellings) <br /> <br />~ Bui~ng system o~er <br /> <br />~ 8ys~m ~r ~0 vel~ <br /> <br />~ Buildi~ ~r2 <br /> <br />~ ~il~ng ~ 10,~ ~uam <br /> <br /> _ ~u~ D~ <br /> <br />~ H~us <br /> <br />Submit 2 seta of p~ns wilh any of file above. <br />Temporary cons~clion service8 do not apply. <br /> <br />SITE #: Pecm[t Ne, <br /> <br />4. FEE SCHEDULE (Complete and enter total in A; below) <br /> <br />Mull~-Femlly per dwelllflg unit <br /> <br /> 1500 sq,, ft,, or less <br /> Each ~"1 ~0 ~, fi,, ~ posen <br /> E~h M fg.'d Ho~ or M0dulm <br /> D~llng ~ ~ f~r <br /> <br /> ~r 1 ~ ~s or ~1~ <br /> R~nn~t On~ <br /> <br /> ~l~s~ <br /> <br /> E~h pu~ or Itdga~n ~sie <br /> ~ch s~n ~ outline I~h~ng <br /> Sign~ cimult(s) or a limll~ enemy <br /> <br />F. Each ed~'l Ins~on <br /> ~r ~ ~l~le In any of <br /> · e ~e. per in~ee <br /> <br /> P~k of 10 r~els ~ $5.~ <br /> <br />__Sos,__ 2 <br /> <br />~ $13o, _, 2 <br />~ $ 3s,, __ 2 <br /> <br />$40. 2 <br />__$80. 2 <br /> <br />~ $35,~ 2 <br />~$15. ~ <br /> <br />~ $36,__ 2 <br />__$36, 2 <br /> <br />Ac Enter total of fees from See. ~ <br />A~.. Add 5% surcharge (.05 x At) <br /> <br /> ,~ubtot~l <br /> <br /> B. Enter 25% of line At for Plan Review <br /> (Sec. 3). if required <br /> C. Im.~esligallee Fee (if required) <br />- D. Reinspe~on Fee ($25,00) <br /> <br /> TOTAL AMOUNT DUE <br /> Receipt No. _ <br /> <br /> <br />