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MARION COUNTY BUILDING INSPECTION <br /> 220 High Sims{ NE <br /> SaJem, Oregon 97301 <br /> <br /> Phone 588-5147 8.'00 a.m. - 4:30 p.m. <br /> Ceda-A-Phoee: 588-7904 SITE #: <br /> PAX: 588-7948 <br /> <br /> Perteit No. <br /> <br />Issued by:: <br /> <br />Description: <br /> <br />I Job No. <br /> <br />Pho.,,.o <br /> <br />Property Owner <br /> <br />City/state/Zip <br /> <br />The Instmlation Is being msde on property i own which Is not Intended for sale, <br /> <br />Owner'8 Signature <br /> <br />PLAN REVlL=W SEClION <br />Check apptoprlato item and entor fee in SanEee <br /> <br />__ Connected Load over 20o amps (except single family dwellings) <br />-- Building system over 200 ernl~ (exeept sJngte fam~ dwellings) <br /> System over 600 volt~ <br />__ Busting over2 sterie= <br />__ Built,rig over 10,000 square feet <br /> . Oc, cupant load OVer 300 persons <br /> <br /> _ Hazadous Lcx:eJbns <br /> <br />Submit 2 sets of plans with any of the above, <br />Teteporar)~ cansUuc~on ~svlees do not apply. <br /> <br />4. FEE SCHEDULE (Complete end enter total in A~ below) <br />Number ed Inspootions per permit allowed ,,, <br /> <br /> A. Residential, Single or <br /> MutiI-Fateby per dwelling unit <br /> <br /> 1500sq. fL or tess <br /> Each addal ~00 scI. ti. or portion <br /> Each Mfg.'d Home <br /> <br /> e. Serdeeffeedere <br /> 'to Bran~ C./r¢~,~/ndude~ <br /> <br /> I01 steps to 400 amps <br /> 401 amps to 600 ampo <br /> <br /> Reco~nec~ Only <br /> <br /> C. Temporary 5el*e'tee~/Feeders <br /> <br /> 200 amps ot les~ <br /> ~O1 amps te 400 an'~os <br /> 401 amps to 600 amps <br /> Over 600 amps or 1000 volts (,see <br /> <br />n. Branch circuits <br /> <br /> One ~teult <br /> <br /> Each add'l ten circuits or podion <br /> <br />E. M~elteneous <br /> ~$ervt~ of F~der nor/~cdu#~d) <br /> <br /> Each pump or irrigation cycle <br /> Each sign or outline lighdng <br /> Signal almult(s) Or a lirilited eheq~y <br /> <br />F. E~h add'l Inspection <br /> over the allowable in any of <br /> · e above, per In.scan <br /> <br /> Pack of 10 labels @ $5.00 each <br /> (,,~o/dan/y to e/ec~/cal con,scars) <br /> <br />H. Other <br /> (As required by Building <br /> <br />Itom~ x Ce~t; TOtal <br /> <br />__$~.__ <br />__Sis. <br /> <br /> ,, <br /> <br />__$35. <br />__$60, <br /> <br />-- $~0,, <br /> <br />, <br /> $80. <br /> <br />__$35, <br />__$50. <br />__$15, <br /> <br />__$36. <br />__$36, <br /> <br />__$50, <br /> <br />2 <br />2 <br />2 <br /> <br />2 <br />2 <br /> <br />Al. Enter tet~ of fees fmte Sec.. <br />A2. Add5% surcharge (.05xAQ <br /> <br />B. Enter 25%oflineA~ for Plan Review <br /> (Se~ 3), if required <br />C. Investigal~ee Fee (if required) <br />D. P~n~pec~on Fee ($~5.00) <br /> <br />TOTAL AMOUNT DUE <br /> <br />$ ~,'7.s- <br /> /. 7~''~ <br /> <br />$ <br />$__ <br />$ <br /> <br /> <br />