Laserfiche WebLink
iFOR OFFICE USE ONLY <br />Received by: <br /> Date: <br /> <br /> MARION COUNTY BUILDING INSPECTION <br /> 220 High Street NE <br /> Salem, Oregon 97301 <br /> <br /> Phone 58S-5147 8:00 am - 4:30pm <br /> Code-A-P~one: <br /> FAX: 5ss.794s SITE #: <br /> <br />ELECTRICAL PERMIT APPLICATION Date: <br />Please1_ .complete all Sections,... I through 5 <br /> Issued <br /> by: <br /> <br />1, LOCATION OFIN,q~'ALLATION <br /> <br />JobAddmss 235 Hill St. <br />City Detroit [ Cr~s St. <br /> <br />D¢~cdpdon upTradin9 service and added <br />odditinal circuits in house <br /> <br />PEKMYI;$ ARE NON-'tRANSFERABLE AND NON-REFUNDABLE AND <br />EXPIRE IF WORK IS NOT STARTED WrEHI~ 180 DAYS OF ISSUANCE <br />OR IF WORK iS SUSPENDED FOR 180 DAYS. <br /> <br />2A. CONTRACI'OR INSTALLATION ONLY <br />EleadealConwacwr A&E E3 Phon~67-9309 <br /> <br />MaillngA4d~a 827 SW 36th Ave., Albany <br /> <br />P~nY Owner Jim Gauell,qgr <br /> <br />Comraeto~s Llcc~s¢ No. 2 2 - 1 1 5 - C <br /> <br />Contractor'S Board Rcs. NO, 7 0 5 0 7 <br /> <br />lobNo. <br /> <br />Supervisor% IA~nse No. ~ 4 6 5 - S <br /> <br />PhoneNo.967-930~ <br /> <br />21], FOR OWNER INSTALLATIONS <br /> <br />Mail~g Addve~ Phone <br />City/Staged-Zip <br /> <br />The instalL'laon b ~cing made on prolmrty I own whiefi is not intended tbr sale, <br /> <br />Ovmcfs Signamre -- <br /> <br /> PLAN REVIEW SECTION <br /> <br /> We will pro¥ide plan review service if you complete Section <br /> 51~ and submit two (2) sets of talons 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 requirexl by the Oregon S~xuctural <br />Specialty Code, Chapter 53, <br /> <br />MC 15-34 11/91 <br /> <br />4, FEE S~2~EDULE (Ccn-nl-,leie ~md ~nt~ total ill Al bclo,~) <br /> <br /> Number of Inspections per permit allowed <br /> <br />A, <br /> Residential <br /> Per <br /> Unit <br /> Service Included: It~"nS Cost (each) 50m/ <br /> <br />1000 sq- fl, or le~ $85.00 ~ <br />Each a~tional 5~ sq. <br /> <br />L~imd E~y <br /> <br />Each Manufd Home or Modular <br />Dwcl~ng Semite or Feeder $40,00 <br /> <br />B. Services or Feeders (Does not ~lcode branch al reuit~, ~e¢ section D) <br /> <br /> Installatlon~ Al~ratloni or Relocation nt <br /> 200 arnl~ or less , ~ <br /> 2,01 amps to 400 amps <br /> 401 amps to 600 arcps <br /> 601 amps to 1000 ampa <br /> Over I000 amps or volts <br /> Rexx:~mcct only <br /> <br />C, Temporary Ser~keafF~ders <br /> Installation, AIteraao~, or Relocatiou <br /> <br /> 40I araps Io 600 amps ~ <br /> <br />D, Branch Circulis <br /> <br /> a) Tha fe~ for bramch el~¢~its w~th <br /> pureha~ ~f seI~Acc or ~er fcc <br /> Each branch circuit ]J~ <br /> <br /> ,Each adrlilional branch ebcuil <br /> <br />E. Miscellaneous (Service or Feeder Not Included) <br /> Each gin'ap or ffrigation circle <br /> <br /> . lgnal larcmt0) or a Ibm ed energy <br /> <br />~b~ ~¢h additional inspection <br /> <br />G. Minor Installatinn Labels <br /> Pack of I0 lahcl~ ~ $5,00 eacl% <br /> <br /> (As required by Building Official) <br /> <br /> iso.o0 <br /> 60,00 <br />$100.00 <br />$130,00 <br />$$00,00 <br />SnO,O0 <br /> <br />$35.00 ~2 <br />$40,00 2 <br />$80.00 2 <br /> <br />$35.00 <br /> <br />$40.00 <br />$40,00 <br /> <br />$40.00 <br /> <br />$35,00 <br /> <br />$50.00 <br /> <br />S. FEES <br /> Al, Enter total of fees from Sec. #4 , <br /> A~, A(Id 5% sureha/ge (.05 x Al) <br /> <br /> Subtotal <br /> <br /> Fl. linler 25% of llne Al for Plan Review <br /> (Sca, 3). if mqulred <br /> C. Invest~galion Fee (if mqni~d) <br /> D. Relnspecoon Fcc ($25,00) <br /> <br /> TOTAL AMOUNT DUE <br /> <br />__ Rcc~ip~ No, <br /> <br />$ J. OO <br /> <br />$73.50 <br /> <br />$ 73.50 <br /> <br /> <br />