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EI,,ECTRV~L PERI~T APFUCA'nON <br />Please ~omplete all Sec~ons, I through 5 <br /> <br />MARION COUNTY BUILDING INSPE(~'I~ON , <br /> -~ !¥ ~ ? ~. ,_~ <br /> Salen~ Omgo~ 97301 ~.~/ ' <br /> <br />28. FOR OWNER INS'I'ALLATK3N~ <br />Property Owner <br /> <br />Mailing Address I pl~one <br /> <br />The ingratiation ia being made on property I own which ia not intended for sale. <br /> <br />Owne t"8 Signature <br /> <br />Check approp~ate item end enter fee in Sec~ 55, <br /> <br /> ,.. Conn,"ted Load over 200 amps (ex,pt single family dwellings) <br />__ ;~ui~dJng system OVer ~ amps (except single family dwellings) <br /> <br />~ System over 600 volts <br /> Building over 2 ,~tei'ies <br />,,. Build/no over to,O00 square feet <br />, Occupant lead over 30o persons <br /> Manufactured Dwela~g PaddRecmafion PeJ'k <br /> H~m~us Local~o~ <br /> <br />Submit 2 Bets of plans wifi3 any of ale above. <br />Temporary ~.onsl~ucfian ~ervices do not apply. <br /> <br />FEE SCHEDULE (Complete a~d enter total in A~ be[ow) <br /> <br /> E~h a~'l ~0 ~.. fl. ~ posen <br /> ~ M~."d Ho~ or M~ular <br /> Dwelling ~ <br /> <br /> 1~a~ <br /> <br /> ~1~ 10~ <br /> <br />C. Tem~ ~tee~F~ers <br /> <br /> ~0 a~ or le~ <br /> ~1 ~Ste <br /> <br /> ~ ~ ~s or 10~ volts (~ 4~ <br /> <br />D. Branch <br />N~. A~ ~ E~ Pw P~el <br /> ~e cimult <br /> <br />~ Mlemllaneous <br /> <br /> E~ pu~ ~ trdga~n <br /> E~h S~ ~ outline lightng <br /> <br />F. ~eh add'l <br /> <br />$80, <br />$130. __ <br /> <br />$35.__ <br /> <br />At. Enter tetal of fees from Se~ ~4 <br />A~. Add5% surcharge (.05xA~) <br /> <br /> ~ubtotal <br /> <br />B. Eater 25% of line A1 fox' Plan Review <br /> (Sec. 3). if required <br />C. Inves~gatim Fee (it moplmd) <br />D,, Ranst~=ion Fee ($2500) <br /> <br /> TOTAL AMOUNT DUE <br /> <br />~$~,__ 2 <br />$~0,__ 2 <br />$80 2 <br /> <br />,., $35.~ 2 <br /> <br />~ $ 31~, ~ 2 <br /> , $36,, 2 <br /> <br />$ <br />$ <br /> <br /> <br />