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IFOR OFFICE USE ~'~LY MARION COUNTY BUILDING INSPECTION <br /> <br /> Received by; ~' .220 ~/igh St~eI NE <br /> Date: Salem. Oregon 9730~1 <br /> · .:',,: <br /> ~.:~-&'m~:~-~r' ;~,. ~/~ PermitNo.~O¢// <br /> ELECTRICAL PERMITAPPLICATION ~ ~,~,¢;; ~'~ ~, ~?' Date: ~/2 N/~ ~ .... <br /> PIoaso,~omploto all Sections, ~ through 5 [ ~ ''~ "~ <br /> <br />P~ ARE NON-q~S~BLE ~ NON-RE~AB~ <br />~E W WO~ ~ NOT STARTED ~ 180 DAYS OF <br />OR ~ WO~ IS SDSP~ED FOR 180 DAYS. <br /> <br />2A. CONTRAUI'OR INSTALLATION ONLY <br />Mailing Addross <br /> <br />Property Ownea' <br /> <br />IPhone <br /> <br />No. <br /> <br />Job No. <br /> <br />~honc. No. <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br />3. PLAN RRVI:~W SECTION <br /> <br /> We will 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 pl$.n review program does not suspend the <br /> t~quirod submission of lighting power calculations, plans, <br /> and specifications when reqnifed by the Oregon Structural <br /> Specialty Code, Chapter 53. <br /> <br />MC 15-34 11/91 <br /> <br />A, R~sldemial Per Unit <br /> Servle~ Included: <br /> <br />$85.00 , 4 <br />$15,00 <br /> <br />1000 zq. ft. or less <br />Each add~ficoa1500 sq, f~ <br /> <br />IAmit~d ~ncrgy $20.00 1 <br />l~aeh Marm£d Home or Modular <br />Dwelling Selwlo~ or Feeder $40.00 2 <br /> <br />~, Sera'ices or Fe.~lers (Does not jnlcude branch cireuhs, see section D) <br /> Inst~llaUon, AIt~'atlons or R~ocatlon <br /> 200 aml~ or less $$0.00 ~' <br /> 201 amp* to 400 ~npa SO0.00 2 <br /> 401 aml~ to 600 amps $100.00 2 <br /> 601 amp~ m 1000 amps $~ 80.00 -- 2 <br /> O,~r 1000 amps or vol~t ~ SgO0.00 <br /> Reco~meet only __ $40.00 ... 2 <br /> <br />C. Temporary Servlc~/Peeders <br /> Installation, Alteration, or Relocation <br /> <br /> 201 amps 'to ~ ~ <br /> <br /> a) ~e f~ for ~ch ~m~ts ~ <br /> <br /> b) ~ f~ f~ bmn~ ~t, wi~out <br /> <br />E. Mtscellan~ua (Service or Feeder Not Included) <br /> Ea~ ~mp ~ ~ga~ <br /> <br /> (As tug,red by Bui~g Office) <br /> <br />$. FEES <br /> <br /> A2. Add 5% s~wha~e (.05 x Al) <br /> <br /> Subtotal <br /> <br />$35.00 <br />$40,00 --2 <br />$80.00 --2 <br /> <br />$2.00 <br /> <br />$35.00 <br /> <br />$40.00 <br />$40.00 <br /> <br />$40.00 <br /> <br />SSO.OO <br /> <br />No. <br /> <br />, 2 <br /> <br /> <br />