Laserfiche WebLink
[DFOR, OFFICE U~SE ONLY <br />Received by~ <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> 2:20 High Street NE <br /> Salem, Oregon 97301 <br /> <br /> Phc~e 588-5147 8:00 am - 4:30pm <br /> Code-A-Phone: 585-7904 <br /> FAX: 5SS-7945 SITE #: <br /> <br />ELECTRICAL PERMIT APPLICATION I <br />Please complete all Sections, i through <br /> <br />LOCATION OF INSTALLATION <br /> <br /> c. <br /> <br />Dire~tlons 3 A~f ~l I d~,- ~ <br /> <br />E~E ~ WO~ iS NOT STARTED ~ 180 DAYS OF ~SU~CE <br />OR ~ WO~ IS SUSP~ED FOR 180 DAYS, <br /> <br /> CONTRACTOR INSTALLATION ONLY <br /> <br />P~01~ey Owner ~ ' ] P~onc <br />Sigaam. of S~is~g <br /> <br />2B, FOR OWNER INffFALLATIONS <br /> <br />Propa~y Owner <br />Mailing Address Phone <br />City/~tatc/Zlp <br /> <br />The installation is being made on propeay I own which is not ~tendad for sale. <br /> <br />Owner's Signature <br /> <br />3. PLAN REVIEW 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 plan review program does not suspend the <br />required submission of lighting power calculations, plans, <br />and spccifidations when required by the Oregon Structural <br />Specialty Code, Chapter 53. <br /> <br />MC 15-34 11/91 <br /> <br />Date: <br /> <br />Permit No. <br /> <br />Issued by: <br /> <br />4. FEE SCHEDULE (Complete ~d enter total ia A 1 below) <br /> Number of Insp~tlons per permit allowed -~ <br /> <br />A. <br /> Residential <br /> Per <br /> Unit <br /> ,. <br /> ! <br /> Service Included: hems Co~t (each) Suml <br /> <br /> 1000ssO. z. ft, orless $85,00 __ 4 <br /> Each a&laional 500 sq- fl, <br /> or por6o~ tbemof __ $15.00 <br /> LinC. md Energy __ $~0.00 -- 1 <br /> Each M~nufd Home or Modular <br /> Dwelling Smwlcc or Feeder $40.00 __ 2 <br /> <br /> Installation, Alterations or Relocanon <br /> 200 amp~ or less <br /> 201 amp~ to 400 amps <br /> 401 :unp~ Io 600 amps <br /> 601 amp~ to 1000 amps <br /> Oven' I000 amps or vohs <br /> <br />C. Temporary Services/Feeders <br /> <br /> 200 amps or less <br /> 201 amps to 400 amps <br /> <br /> Over 600 ~rnps or 1000 volts <br /> <br /> a) The fee for branch 6reuits with <br /> purchase of service or <br /> <br /> Each branch circuit <br /> <br /> b) The fee for branch cireuts without <br /> rehage of se '¢ <br /> / <br /> Each additional branch cimuit <br /> <br />E. Misceltsn~ons (Service or Fee~er Not Included) <br /> Each pump or ini§atior~ circle <br /> Each sign or ou61n~ lighting <br /> Signal circuit(s) or a lh~tad energy <br /> <br />E Each additional Inspection <br /> over thc allowable in any of the <br /> <br />G, Minor Installation Labels <br /> Pack of 10 labels @ $5.00 each <br /> (sold only to electrical contractors) <br /> <br />I~, Other <br /> ( As requlr~d by 8uildlag Official) <br /> <br /> ~50,00 2 <br /> 60.00 __2 <br />$100.00 2 <br />$130,00 __ 2 <br />$300,00 __ 2 <br />$40,00 __ 2 <br /> <br />$35.00 <br />$40,00 2 <br />$80.00 <br /> <br />5, FEES <br /> A I, I~nter total of fees from Sca. #4 <br /> A2, Add 5% surcharge (.05 x Al) <br /> <br /> Subtotal <br /> <br /> B, g~tsr 25%of lineAl for PlanRevinw <br /> (See. 3), if required <br /> C. iave.~tigalionFcc (ff required) <br /> D, Reinspeeaon Fee ($25.00) <br /> <br /> TOTAL AMOUNT DUE <br /> <br /> Receipt No, , , <br /> <br />$2.00 <br /> <br />$ s.oo <br /> $2.00 <br /> <br />$40.00 <br />$40,00 --2 <br /> <br />$40,00 <br /> <br />$35,00 <br /> <br />$50,00 ............ <br /> <br /> <br />