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OPRCE USE ONLY <br />Received I:~. ~ <br />Date: <br /> <br />ELECTRICAL PERNEr APPLICA'RON <br />Please ~omptete ~l Sec~ons, I through5 <br /> <br />MARION COUNTY BUILDING INSPEC'RON <br /> 220 High Slmet NE <br /> <br /> Issued by: <br /> <br /> · . FEE~HEDULE (Compte~denter~ hA1 b~) <br /> Number ~ Inactions ~r ~rmlt all~ <br /> <br /> ~ ~sl~ntlel, Single ar I~ma x ~at: To~l <br /> <br />21EL FOROWNERi~STALLA'IX~ <br />Iprope~tyOwner <br />Mailing Address '1 Phone <br />CttylS'~,te/Zip <br /> <br />The instsllatlon l~ being made on property I own which ia not intended for sale, <br />lease or rent. <br /> <br />OwneCs Signature <br /> <br />Multi-Family per dwelling unit <br />(s~/ndud~ <br /> 1~00 sq. ft or less <br /> <br /> E~h Mfg."d Ho~ or M~u~r <br /> D~lllng ~ or f~r <br /> <br />c. Tem~m~ <br /> <br /> Two~ ~n ~ <br /> <br />E. ~s~llaneeus <br /> <br /> ~h s~n or eelline lighting <br /> ~n~ clair(s) or a ~mi~ enemy <br /> <br />F. ~h edd'l tos~on <br /> <br />~ ~er <br /> <br />2 <br /> <br />2 <br />2 <br /> <br />PLAN REVIEW SECTION <br />C/~¢k appropriate item a/~/ en~ar f~e in .%go, on 5B. <br /> <br />Connected Load over 200 amps (exeept single family dwellings) <br />Building system over 200 amps (exa~pt single family dwellings) <br />System over 600 volts <br />Building over2 stories <br />Building over 10,000 ~luam feet <br />~pent lead over 300 persons <br />Manufa~umcl Dwelling Pal~Re~mafion Pad< <br />Hazardous Locations <br /> <br />Submit 2 sets of plans with any of the above. <br />TemporaE coasa~tlon sewicee do not apply. <br /> <br />B, I=mer 25% of line A1 for Plan Review <br /> (Sec. 3). if required <br />C. Invesligalion Fee (if required) <br />D. Reinspe~on Fee ($25,00) <br /> <br /> TOTAL AMOUNT DUE <br /> <br /> <br />