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MARION COUNTY BUILDING INSPECTION <br /> <br />Please complete all Sections, i through 5 <br /> <br /> 220 High Street NE <br /> Salem, O~on 97301 <br /> <br />Phozm 588-5147 8:00 ~ma - 4:30pm <br />Cod~-A-Phmm: 588-7904 <br /> FAX: 588-7948 <br /> <br />ELECTRICAL PERMIT APPLICATION <br /> <br />SITE #: <br /> <br />Date: <br /> <br />Issued by: <br /> <br />PermJtNo. <br /> <br />PERM1TS ARE NON-TEAN~FE~ABL~ AND NON.EEF~NDABLE AND <br />E~FE~E IF WOEK IS NOT STARTED ~ 1 ~0 DAYS OF I~SUANCE <br />OR IF WORK IS SUSPENDED FOR 150 DAYS, <br /> <br />2A. CONTRACTOR TNgTALI.ATION <br /> <br /> PAR}<IN ELECTRIC,/ INC. <br /> 20250 S MBLALL, A AVENUE <br /> OREGON C',[TY, (3R 970':~5 <br /> 246-1301 <br /> <br /> CON"rRAC]'OI~S LIC:ENSE ~:~ 34-4C <br /> CONTRACTORS BOARD REa. # 35151 <br /> SUF'ERVISOR '10 131~-S <br /> <br />Supu~oe~-~M,~s~ No, ~ No. <br /> FOR O~ER IN~ALLATIONS <br /> <br />a Pmpur~ Owner <br />Ma~jng Address Phone <br />C~y/Stam/Zip <br /> <br />Thc inatallafion is being made ma pml~tty I own which is ~o{ inreadrxl for sale, <br /> <br />OwneCs Signature ,,, <br /> <br /> 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, phns, <br /> and specifications when required by the Oregon Structural <br /> Specialty Code, Chapter 53. <br /> <br />MC 15-34 11/91 <br /> <br />4. FEE SCHEDULE (Comp[crc and e~t~r total in A1 below) <br /> <br /> / <br /> <br />Each additional 500 sq, f~, <br />or purd.~ tbe, mof $1 $.00 <br />Limited lluergy $20,00 __ I <br /> <br /> Dwelling So.dee or Feeder ~,/' $40,00 -- 2 <br /> <br />B. Services or Feeders (Do~s not hdcudc branch aimalts, sca section D) <br /> <br /> 200 amps or less <br /> g01 araps to 400 amps <br /> 401 anaps to 600 amps <br /> 601 ampa to 1000 m~ps <br /> Over 1000 amps or volts <br /> Reconnect <br /> <br />C. T~mporary Services/Feeders <br /> Installation, Alteration, or Relocation <br /> 200 amps or <br /> 201 ~anps to 400 mnps <br /> 401 amps to 600 an: <br /> Over 600 ~rnps or 1000 volts <br /> <br />D. Branch Cl~uits <br /> New, Alteration, or Rxtension Per Panel <br /> <br /> a) Tho fcc for bnnch circuits with <br /> ~urch~s~ of s~rvle~ or feezS, ey..fe~. <br /> <br /> Each branch <br /> <br /> b) Th~ fm fo~ branch drcms <br /> <br /> First branch eimint <br /> Each addit~on~tl brach cil~llit <br /> <br />E. Miscellaneous ($erviee or )Pee~er Not included) <br /> Each pump or irrigat;[on eAteAe <br /> Each sign or outlln~ l~hti~g <br /> Signal c~rcuit(a) ~¢ a limited <br /> panel, altcradon or extension <br /> <br />F. Each additional Inspection <br /> over the allowable in any of the <br /> <br />O. Minor Installation Labels <br /> Pack of 10 lat~ls @ $5,00 each <br /> ($Old only to electrical cor~ractor$) <br /> <br />H. Other <br /> (As required by BuEding Official) <br /> <br />S. FEES <br /> AL Enmr tm, al of fees from Sec. #4 <br /> A2. Add 5% sutcha~g= (.05 x Al) <br /> <br /> Subtotal <br /> <br /> E. Ent~r25%ofl[~eA1 for Plan Review <br /> (Se=. 3). if reqalreA <br /> C. Investigation Fe~ (if ~ltdmd) <br /> D. Reinspucti~m Fee ($25,00) <br /> <br /> TOTAL AMOUNT DUE <br /> <br />50.00 <br />~80.00 <br />$100.00 2 <br />$130.00 ........... 2 <br />$300.00 __2 <br />$40,00 __ 2 <br /> <br />$35.00 <br />$40.00 <br />$80,00 <br /> <br />$2,00 <br /> <br />$35.00 <br /> $2.00 <br /> <br />40.00 <br />~40.00 2 <br /> <br />$40.00 2 <br /> <br />$35.00 <br /> <br />$50,00 <br /> <br /> <br />