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FOR OF.FICE USE ONLY <br />Received by: <br />Date: " <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete all Sections, I through 5 <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br /> 220 High Street NE <br /> <br /> Phone 588-5147 8:00 am · 4:30pm it No. <br /> <br /> Date: <br /> ~,~I:~I,ON COUNTY <br /> lJl[ lN( i ON <br /> <br />pgRMI'IX3 ARE NON.TRANSFERABLE AND NON-REFUNDAB L8 AND <br />EXPIRE IF WORK IS NOT STARTED WTY!4IN 180 DAYS OF ISSUANCE <br />OR IF WORK Is SUSPENDED FOR 180 DAYS, <br /> <br /> CONTRACTOR INSTALLATION ONLY <br />Ele~oalc~,t~¢,o~ f~, ~(e.c~+r/6iP,onc3¢g_0770 <br /> <br />Job No. <br /> <br />2B, FOR OWNER INSTALLATIONS <br /> <br />Peopeay Owner <br /> <br />Owners Signature <br /> <br />3. PLAN REVIEW SECTION <br /> <br />We wilt provide plan review service, if you complete Section <br />5B and submit two (2) sets of plans and specifications with <br />this application, <br /> <br />This optional plan review program does not Suspend the <br />required submission of lighting power calculations, plans, <br />and specifications when required by the Oregon Structural <br />Specialty Code, Chapter 53, <br /> <br />4, FEE SCHEDULE (Complete and enter tolal in A1 below) <br /> <br /> Residential <br /> per <br /> Unit <br /> <br />I000~q. fL or less $85.00 <br />Each additional 500 sq, fl, <br />or pOrfic~ thereol $15.00 <br />Limil~d Energy $20.00 <br />Each Man0fd Home or Modular <br />Dwelling Sem~ or Feeder $40.00 <br /> <br /> 50,00 <br /> 200 amps or less ~60.00 <br /> 4(~I a~ps to C~O amps $100.00 <br /> 60I am~ to 1000 amps $150.00 <br /> Over 1000 amps or vohs $300.00 <br /> <br />12. Temporary Servlces~eefl~ra <br /> <br /> 200 amps or less <br /> 201 amps to 400 amps $40.00 <br /> 401 amps to 600 amps $80.00 <br /> <br />D. Branch CircuiL~ <br /> <br /> a) 'lhe fe~ for branch circuits <br /> <br /> Each br,'mch circuit $8,00 <br /> <br /> b)The fee for branch circuts .without <br /> pureb~.gf service or feeder <br /> <br /> Each additional branch cffcuit $2.00 <br /> <br /> Each pump or irrigation circle $40.00 <br /> Each ~ign or outfinc ligh~lg $40.00 <br /> <br /> panel, alteration or extension $40.00 <br /> <br /> above, per In s~ccfion $35.00 <br /> Pack of 10 labels @ $5 00 each ~ $80.00 <br /> <br /> (As required by Building Official) <br /> <br />"'~. FEES <br /> <br />A 1. ~ntcr Ic, lal of fees from Sec. #4 <br />A2, Add 5% surcharge (.05 x A l ) <br /> <br /> Subtotal <br /> <br />B. Enter 2.5% of line A 1 for Plan Review <br /> (See. 3), if ~quired <br />C. Investigation Fee (ff required) <br />D, R¢in~l?xtim Fe~ ($2,5,00) <br /> <br /> TOTAL AMOUNT DUE <br /> <br />$ 0 OD <br />$d03- oo <br /> <br />$ <br /> <br />MC 15-34 11/91 Re. ceipt No. <br /> <br /> <br />