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ELECTRICAL PER~JT APPLICATION <br />Please ~on~:~te ~ ~, l ~rou~h 5 <br /> <br />MARION COUNTY BUILDING iNSPECTION <br /> 220 High 9.reel NE <br /> SaJen~ Oregon 97301 <br /> <br /> Phone 588~147 8:00 a.m. - 4;30 p.m. <br /> Code-A~'b:me: 588-7904 SITE,: ~ <br /> <br />Description: <br /> <br />Electrlcai C~ntrect~7~ ~L~) ~'~___~ <br /> <br />Properly Owner <br /> <br />r-oR OWNER EXIEI'ALLA~ <br /> <br />Property Owner <br />Mai[lng Address <br /> <br />Phone <br /> <br />The installation is being made on property I own which is not Intended for sale. <br /> <br />Owner's Signature <br /> <br />4. FEE SCHEDULE (Complete and er~ktf tolaJ in At below) <br />Number of InslxCt{ons per permit allowed <br /> <br />(70/~an~h C#~u/~s <br /> <br /> lo~ ~to~ -- $ ~, -- <br /> <br /> R~n~t~ ~ $ ~. ~ <br /> E~ s~n ~ outli~ I~h~ng ~ $ ~. ~ <br /> <br />2 <br />2 <br /> <br />2 <br />2 <br />2 <br /> <br />2 <br />2 <br /> <br />2 <br />2 <br /> <br />2 <br /> <br />3. PLAN REVIEW SEClrIoN <br /> c/~ck ap/xop~te ~em and emir fee/n S~=~on 5B. <br /> <br />__ Connec~d Load over 200 amps (except single family dwellings) <br />__ Building system over 200 amps (exsept simile family dwellings) <br />__ System over 600 volts <br /> I-~uitdlng over2 stories <br />__ I~tlding ove~ 10.000 square feet <br />-- O~upant load ov~ 300 persons <br />__ Manure--lured Ehtmlllng Park/Recreation Park <br />__ Hazardous [.cK;a/~ons <br /> <br />Submit 2 sets of plans with any of ~e above. <br />Temporary senstru~on services do not a,,Aoly. <br /> <br />A'i. Ente~ to{al of fees lmm Se~. #4 $, <br />A~. Add ~ <br /> <br /> Sub~ $. <br /> <br />B. En~ ~% of line <br />(~ ~), <br />C. In~s~ Fm (~ ~i~) $. <br />D, ~ ~ ~,~) $ <br /> <br /> TOTAL A~NT DUE $ <br /> <br /> <br />