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OR,CE ~ ONLY <br />Received by: <br />Date: <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete a8 Sections, I through 5 <br /> <br />1. LOCA]ION OF INSTALLA'IlJ3N <br /> <br />2~. FOR OWNER INSTAU..A'noNs <br /> <br />Cfty/StAtel Z~p <br /> <br />4. FEE .~CHEDULE (Complete and enter total in A~ below) <br />Number of Inspe~tlees per permit <br /> <br /> 1 <br />M~l~-Famlt)' pet dwelltng untt <br />( $emlce inclu d~d) <br />1500sq_fl. orless ~ $ 85. __ 4 <br />Ea~add1~00sq. ft. orportlon ~ $ 15. __ <br /> · Ea~h.M~j..'d.Home or ModUlar ' ~':,: <br /> Dwelling servlce0r feeder __ $ 35. .~ 2-'" <br /> <br />B, ~etvlee,,Feeders <br />(1o Branch Circuits Included) <br /> <br /> 10Oar~p~orless ~ $ 35. __ 2 <br /> 101amps to 400 arnp~ __ $ 60. __ 2 <br /> 401amps to 600 amps ~ $ 80. 2 <br /> 601 amps ~ 1000 amps $130. -- 2 <br /> <br /> Re~onneetOnly -- $ 35. -- 2 <br /> 200 amps or les~. $ 35_ 2 <br /> <br /> Over 600 amps o¢ 1000 volts (~ee 4B) <br /> <br /> OneeJrcuit l $ 35, ,~00 2 <br /> Eachadd'ltenclreuitsorportJan . $ IS. . .... <br /> <br /> Eschpumporlnfga~ancycle __ $ 36. <br /> <br /> ffte above, per in~4~ec~ion $ 35, <br /> <br /> Pa~kofl01abels@$5,00eech $ 50 __ <br /> (Sold on~ to electrical concaves) <br />14, Other <br /> (,4~ requlr~l by Sui~ng <br /> <br />3, PLAN REV~E~ $E-Cg]ON <br /> Check appropriate item and enter fee in ,~:#en ~B. <br /> <br /> . Connec~d bgad over 200 amps (except single family dwellings) <br />__ Bui~mg system over 200 amps (except s/~gle family dwellings) <br /> System over 600 vottS <br /> <br />~ Buifdlng over2 stories <br /> <br />~ B~ilding over I0.000 square feet <br /> Occupant loewi over ...'~)0 persons <br />__ Manufac~md Dwening Park~Rec~at~on Park <br />__ Hazardous Local~ons <br /> <br /> Submit 2 sets of plans with any of ~ above <br /> Temporary consblmtton sewic~s do not apply. <br /> <br />MC 15-3~ R~,,, 7/30 <br /> <br />A~, Enter total of fees from Sec, it4 <br />A2. Add 5",'. surcharge (.05 x A9 <br /> <br /> Subtotal <br /> <br />B. Enter 25% of line A~ for Plan Review <br /> (Sec. 3)~ if required <br />C. Inves6gatten Fee (if required) <br />D. Reinspec~o, n Fee ($~,,00) <br /> <br /> TOTAL AMOUNT DUE <br /> <br />$ <br />$ , <br /> <br /> <br />