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~ E U "' MARION C, OUNTY BUILDING INSPECTION <br />FORD C SE ONLY ', 220Hi hSt~eetNE ~ ~ <br />I?i,., by:~ ) Sale~, ~gon 97301 ]~ ~ <br /> <br /> ~ ~-~-~: 58s.7~ S TEn' ~ <br /> <br />1, LOCATION OF INSTALLATION <br />Job Adth~ss <br /> <br />Direaions <br /> <br />PERMITS ARE NON-TRANSFERABLE AND NON-REFUNDABLE AND <br />EXI~RE IIn WORK IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE <br />OR IF: WORK IS SUSPF2',ID ED FOR 1 SO DAYS, <br /> <br /> CONTRACTOR INSTALLATION ONLY <br /> <br />~ Owner <br /> <br />FOR OWNER INSTALLATIONS <br /> <br />property Owncr <br />Mailing Address Phonc <br />City/St ated'Z, ip <br /> <br />Owner's Signature <br /> <br />3. PLAN REVIEW SECTION <br /> <br />We will provide plan review service if you complete S<tion <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 S3. <br /> <br />MC 15-34 11/91 <br /> <br />$85.00 __ 4 <br /> <br />$15,00 -- <br />$20.00 -- 1 <br /> <br />A. Residential Per Unit <br />Service Included: <br /> <br />lO00ssO. ft. or less <br />Each a~lditional 500 sq. <br /> <br />Each Manofd Home or Medolar <br />Dwelling Sc~vic~ or l%cdcr $40,00 __ 2 <br /> <br /> Instullanon, Alterations or Relocation <br /> 50.00 <br /> ~0 amps or lca$ $ ~60,00 __ <br /> ~01 m'nF~ to 400amps __ 2 <br /> 401 amp~ to 600 :traps $100.00 ,, 2 <br /> 601 amq~to 1OO0 amp~ $~0.00 __ 2 <br /> Owr 1000 amps or volt-~ $$00.00 2 <br /> P, eco~¢ct o~I¥ $40,00 -- 2 <br /> <br />C. Tempurary Serch:ts/Feedes <br /> <br /> 200 amps or less $35.00 __ <br /> 40.00 <br /> 20t ~nps to 400 amps $ ~80.00 __ <br /> 401am aw6OOam ~ __ 2 <br /> O~¢r ~ ~p* or 1~0 voI~ <br /> <br />D. Branch Circuits <br /> <br /> a) Thc f~ for branch clmait~ with <br /> <br /> Each branch circuit $2,00 <br /> b) TBe fee ~o~' branch drcuts without <br /> <br /> First branch cLr~uit <br /> Each additional branch ck~ult $2.00 <br /> <br />E. Miscellaneous (Service or Feeder Not Inetuded) <br />Each pump or LilisaIic~ circle $40.00 __ 2 <br />Each sign or outline Lighting $40.00 __ <br />Signal circuit(s) or a Limited energy <br />panel, alteration ot ext eatslon $40.00 <br /> <br />E Each additional Inspection <br /> <br /> above, per Inspection $35,00 <br /> <br />0, Minor Installation Labels <br />Pack of 10 labels @ $5.00 each __ <br />(*old only to electrical cora,'actors) <br /> <br />H. Other <br /> ~ As required by Building Official) <br /> <br />5. FEES <br /> At. ~nmr total of f~cs from Sac. #4 <br /> A2. Add 5% sutchaeg¢ (,05 x Al) <br /> <br /> Subtotal <br /> <br /> B. Enter 25% of tine A ! for Plan Review <br /> (Se.c. 3). if required <br /> C, ~t~vcstigatinnF~ (if required) <br /> D. Reinspeeticra Fee <br /> <br /> TOTAL AMOUNT DUE <br /> <br /> Reecipt No, <br /> <br /> <br />