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IFOR OFFICE USE ONLY <br /> Received by: <br /> Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br /> Salem, Oregon 97301 <br /> <br /> ~e-A-~c: ~88-7~ SITE ~: <br /> <br />ELECTRICAL PERMIT APPLICATION <br />P/ease complete all Sections, I through <br /> <br />Date: <br /> <br />Issued by: <br /> <br />PermitNo. <br /> <br />Descfipt/on <br /> <br />pERMITS ARE NON-TRANSFERABLE AND NON -I~P'IJ NDABL.~cDE----=~ <br />EXPII~E ~ WO~ IS NOT STAK~D ~ l~0 DAYS OF ~SU~CE [ <br />OR IF WORK IS $USP~ED FOR 180 DAYS, J <br /> <br />CONTRACTOR INSTALLATION ONLY <br /> <br />lB. FOR OWNER INSTALLATIONS <br /> <br />Ptoger~y Owner <br />Mailing Add.ss I phcme <br /> <br />Ctty/StateL£ip <br /> <br />'I~o installation is being made on prop;rty I own which is not intended for sale, <br /> <br />MC 15-34 11/91 <br /> <br />afionswi~ <br /> <br />,end the <br />tlS, plallS, <br />Structural <br /> <br />4, FEE SCIfIEI)ULE (Complete and enter total in A I below) <br /> <br />A, R~identlal Per Unit <br /> Service Included: <br /> <br /> Items Cost (each) Sum! <br /> <br /> $85.00 ............. 4 <br />1000 sq, ft, or lass .... <br />Each additinnal 500 sq- fi, <br />or ponio~ thereof $15. O0 <br />Lknl~d E~o~gy ~ $20,00 1 <br /> <br />Bach M~ufd HcJm¢ or MmdoJar <br />Dwelllng Service or Feeder $40.00 2 <br /> <br /> 200 amp~ or le~ ~ $60.00 ~ <br /> 201 amps to 400 amps · --~-- <br /> 401 amps to 600 amps $100,00 ~ <br /> 601 amps to 1000 amps ~ $130,00 ,,, 2 <br /> Over 10CO amps o~ volt~ ~ $300,00 __ 2 <br /> R~connect ~n~y ~ $40,00 .... 2 <br /> <br />C, T~nporary Services/Feedee <br /> <br /> a) TI~ fo~ f~r branch <br /> <br /> F~t bran~ ~rc~t <br /> Each ~diti~t branch ~[~ .... [, <br /> <br /> E. Miscellant~ms ($er~ine or Fee~er N~t Included) <br /> Each sign or ou~a <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 ....... 2 <br />$40,00 ...... 2 <br /> <br />$40.00 2 <br /> <br />$35.00 <br /> <br />$50.00 <br /> <br />5. FEES <br /> A 1. Enter total of fees from Sec. #4 <br /> A2. Add 5% surcha~g~ (.05 x Al) <br /> <br /> (Sec. 3), if required <br /> C- Inv~stigationF¢¢ (if required) <br /> D. Reinspectic~a Fee ($25.00) <br /> <br /> TOTAL Ab~.O[JN'I' DUE <br /> <br />Receipt No, <br /> <br /> <br />