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FOR OFFICE USE ONLY <br />Received by: <br />Date: <br /> <br /> MARION COUNTY BUILDING INSPECTION <br /> 220 High Street N~ <br /> Salem, Oregon 97301 <br /> <br /> Phone 588-5147 8:00 am - 4:30pm <br /> Cod¢-A-l~one: 588-7904 <br /> FAX: 588-7948 SITE #: <br /> <br />ELECTRICAL PERMIT APPLICATION Date: <br />Please complete all Sections, I through 5 Issued by: <br /> <br />PermltNo, <br /> <br />L LOCATION OFINSTALLA'rlON <br /> <br />PEI'~M1TS ARE NON-TRANSFERABLE AND NON-REFUNDABLE AND <br />EXPJRB ]P WORK IS NOT STARTED wrrH]~N 180 DAYS OF ISSU~CE <br />OR IF WORK IS SUSPENDED FOR 180 DAYS, <br /> <br />2A, CONTRA(YFOR INSTALLATION ONLY <br /> <br />2B. FOR OWNER INSTALLATIONS <br />Property Owner <br />Mailing Address Phone <br />CAty/State/Zip <br /> <br />The installation is being made on pmpe~y I own which is not intended for sale, <br />lease, tn met. <br /> <br />3. PLAN REVIEW SI~'I'ION <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 specifications when required by the Oregon Structural <br />Specialty Code, Chapter 53. <br /> <br />MC 15-34 11/91 <br /> <br />4. FEE SCHEDULE (Complete and enter total in A1 be]ow) <br /> <br />A, Re~identtal Per Unit <br />Service Included: <br /> <br />1000 sq, fi, or less <br />Each additional 500 sq. ft, <br />or rli.?, tbereof $15.00 <br />Limitc~ncrgy $20,00 <br />Each Manu£d IIome or Modular <br />Dwelling Semiee or Feeder $40,00 <br /> <br />B. Services or Feeders (Docs not inlcude bn~nch circuits, see ~ectinn D) <br /> Installation, Ancrations or Reloc*tinn <br /> <br />Items Cost (caen) Sum/ <br /> $85.00 ............ 4 <br /> <br />2 <br /> <br /> 50.00 <br /> 200 amps or less ~'~60.00 <br /> 201 amps to 400 amps <br /> 401 amps to 600 amps $100.00 2 <br /> 601 amps to 1000 amps $1S0.00 __ 2 <br /> Over 10130 amps Or volt* $800,00 2 <br /> Reoonnecl oaly $40,00 __ 2 <br /> <br />C. Temporary'Services/Feeders <br />Installation, Alteration, or R~qocation <br />200 amps or less $36,00 __ 2 <br />201 amps to 400 amps $40,00 __ 2 <br />401 amps to 600 amps $80,00 2 <br />Over 600 amps or 10130 volts <br /> <br />D, Branch Uircnas <br /> <br /> a) Thc fee for branch cir¢oils with <br /> <br /> Each branch circuit $2.00 <br /> b) Tee fee for branch drcuts wi~op[ <br /> <br /> First branch circuit $35.00 <br /> Bach additional branch circuit $2,00 <br /> <br />E, Miscellantam/(Service or Feeder Not Included) <br /> Each pump or irrigation circle $40.00 I 2 <br /> Each fign or outiLne lighting , __ $40.00 -- 2 <br /> Signal cimuit(s) or a limited energy <br /> panel, alteration or extension $40.00 __ 2 <br /> <br />E Each additional Inspection <br />over the allowable Jn any of the <br />above, per Inspection $35.00 <br /> <br />G. Minor Installation Labels <br /> Pack of 10 labels @ $5.00 each $50.00 <br /> <br />H, Other <br /> (AS required by Buildisg Official) <br /> <br /> FEES <br />A 1. Enter total of l~cs fronl Sec. #4 <br />A2. Add 5% ~urcharge (,05 x Al) <br /> <br /> Subtotal <br /> <br />B. Enter 25% of En¢ Al for Flan Review <br /> (Sec. 3), if required <br />C- InvestlgationFee (if required) <br />D. Remspectlon Fee ($2.5.00) <br /> <br /> TOTAL AMOUNT DUE <br />Receipt No, ,,,,,::. <br /> <br /> <br />