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Date: <br /> <br /> ELECTRICAl_ PERIVIFr APPtJC_,A'IrION <br /> P~as~ conga a//Sect~bns, 1 through $ <br /> <br />LOCA'~'~ OF INSTALLATION <br /> <br />MARION COUNTY BUILDING INSPECTION <br />220 high Street NE <br /> Salem, Oregon 97301 <br /> <br /> Phone588-5147 8~0am-4Ct0pm <br /> <br /> FAX:: 588-79.48 <br /> <br />Job Address <br /> <br />Electrical Contractor <br /> <br />Mailin9 Addres~ <br /> <br />Property Owner <br /> <br />2EL FOR OWNER I~ISTALLATION$ <br />Propert~ Owner <br />M~lllc~g Address I Phone <br /> <br />3, PLAN REVIEW S~ <br /> Check appr~p~am item and en~r fee in Sec~on SB, <br /> <br /> Connected Load ~r ~ ~ps (ex~ ~ ~ily ~li~s) <br /> <br />~ Bui~ng sys~ war ~ ~ps (ex~ s~ ~i~ ~[i~s) <br /> . Sys~m ~er ~ ~1~ <br /> <br />~ Building ~er 2 <br /> <br />~ ~u~ ~ p~ p~ <br />~ H~s <br /> <br />Submit 2 sets of plains wi~ any of the EC~ove <br />Tempo. ra~ c~'~slruclJon services do not al~oiy <br /> <br />Permit No <br /> <br />Issued by <br /> <br />4. FEE SCHEDULE (Complete and enter to~l in A~ below) <br /> <br />Multi.Family per dwelling unit <br />(Ser vice lncluded) <br /> <br /> Each add'1500 sq ft, or portion <br /> <br />B, Servlc~l~eeder~ <br /> I 0 8~anch Circul~ k~cluded) <br /> <br /> lOl aw~s te 4OO amp~ <br /> 401 amps te 600 ampo <br /> 601 er~o~ to 1 <br /> Over 1000 amps or volts <br /> Reconnect O~y <br /> <br />C. Tempemry <br /> <br /> 4Ol amps to 600 empo <br /> Over 6OO amps o~ 1000 volts (See 4S) <br /> <br /> (Sold only to elec~ic, al conYacts~s) <br /> (A~ ~equirod by Building Official) <br /> <br />$ 15 <br /> <br />__S35, 2 <br />__$60, ,,, 2 <br />$80. 2 <br />$130 2 <br />$300. 2 <br /> <br />$4o 2 <br />__$80 2 <br /> <br />$35, 2 <br />$50 ~ <br />$ 15 2 <br /> <br />$:36. 2 <br /> <br />A~. Enter tot~ of fees from ~II ~ <br /> <br /> ~b~ <br /> <br />B. Ent~ ~% of line A~ ~ P~n ~ <br /> (~ 3), if ~u~ <br /> <br />D ~.~n Fm ($~.~) <br /> <br /> ~TAL ~UNT DUE <br /> <br /> <br />