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MARION COUNTY BUILDING INSPECTION <br /> <br />220 High Street NE <br />Salem, Oregon 97301 <br /> <br />Phoa~ 5 $8-5147 8:00 am - 4:30pm <br />Code-A-l~one: 588-7904 <br /> FgX: 588-7948 <br /> <br />SITE #: <br /> <br />Date; <br /> <br />Issued by: <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete all Sections, I through <br /> <br /> ~/~iON ~uuJ~l~ <br />BLI!! nlNn !N.~PFRTInN <br /> <br />I. LOCATION OFINSTALLATION <br />Job Address J~ ~ <br /> JCros~ St, <br /> <br />The hlstal.laGort ia being m~d~ oil pt~?a~-y [ OWrt w~J. ck ia ncr J~telltded <br /> <br />PLAN REVIEW SECTION <br /> <br />We will provide plan review service if you complete Section <br />513 and submit two (2) sets of plans and specifications w~th <br />this application, <br /> <br />This optional plan review program does not suspend thc <br />required submission of lighting power calculations, plans, <br />and specifications when required by the Oregon Structural <br />Specialty Cede, Chapter 53. <br /> <br />MC 15-$4 11/91 <br /> <br />4. FEE SCHEDULE (Complete and eater total in A1 below) <br /> <br /> Per <br /> / <br /> <br /> $85,00 . ,, <br />Each afl&floreal 500 sq. ft. <br /> <br />L~ited E~y $~0,00 ~ 1 <br /> Dwe~g Se~ or Feeder $40,00 ~ 2 <br /> <br /> lns~llatlon,~ am~ ~ Al~atlOnSle~s or Rel~ation / $50.00 <br /> ~er 1~ ~ps or volts $~00,00 <br /> <br /> ~%~0 ~ps or 10~ volts <br /> <br /> Bach ~mp ~ i~gafi~ circle ~ $40.00 2 <br /> <br /> a~ve, per fn~pecfion $35,00 <br /> Pack of 10 la~s ~ $5,00 each $50,00 <br /> <br />5. FEES <br /> <br /> Al, Enter total ofl~e~ from Sec. #4 <br /> A2. Add 5% sumharg~ (.05 x A 1) <br /> <br /> Sobtotal <br /> <br /> B. Enter 25% of llne A1 for Plan Review <br /> <br /> TO1AL AMOUNT DUE <br /> <br />$ <br /> <br /> <br />