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FOR OFFICE USE ONLY I MARION COUNTY BUILDING iNSPECTION <br />Date: Salem, Oregon 97301 <br /> <br /> Phone 588.5147 8:00 am. 4:30pm <br /> Cod¢-A-Ph~me: 58S-7904 <br /> FAX: SSS-?~S SITE #: <br />ELECTRICAL PERMIT APPLICATION I Date: <br />Please complete all Sections, I through 5I Issued by: <br /> <br />DIARION COUN[Y <br /> <br />1, LOCATION OFINSTALLATION <br /> <br />pERMITS ARE NON-'IRANSFEIL~BLE AND NON-REEUNDABLE AND <br />EXP/RE IF WORK IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE <br />OF. IF WORK IS SUSPENDED FOR I gO DAYS. <br /> <br />lA, CONTRACI'OR INSTALLATION ONLY <br /> <br />COmracto~sl~oardReg. No, ~,~.~, I,oh o, ~_ <br /> <br />4, FEE SCHEDULE (Complete a~d enter total in A1 below) <br /> Number Of Iltspeetions per permit allowe~ ~ <br /> <br />A. <br /> Residentlal <br /> Per <br /> UnR <br /> 1 <br /> <br /> or ~ ~ercof $15.00 <br /> Each Man~c or M~ular <br /> <br /> 50.00 <br /> 200 amps or less ~ 1~$0,00 <br /> 20I amps to 400 mnp~ <br /> 401 amps to 600 amps ~,, $100.00 <br /> 60[ aml~ [o 11300 amps $130,00 <br /> Over 10130 ienps or volta $~00,00 <br /> Reeotlnect only $40,00 <br /> <br />C+ 3'emporary ServJCeS~Peeders <br />Installation, Alteration, or Relocation <br />200 amp~ or l~ss $35,00 <br /> <br /> 401 mpa to 600 amps $80.00 <br /> Over 600 amps or 10130 volts <br /> <br />D. Eranch CirPult~ <br /> <br /> a) The fee for br,'rah clrco~ta with <br /> <br /> Each branch eimuit $~.00 <br /> <br /> b)Ihe fee for branch drcll[s without <br /> Imrehas~ 9{.s.e~ice or feeder ~¢~ <br /> <br /> First bra~ch circuit $3~,00 <br /> <br />Zg. FOR OWNER INSTALLATIONS <br />property Owner <br /> <br />Mailing Address <br /> Phone <br /> <br />Chy/Slal~rZip <br /> <br />3. 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 />mquirext submission of lighting power calculations, plans, <br />and specifications when required by the Oregon Structural <br />Spcciahy Code, Chapter 53, <br /> <br />MC 15-34 11/91 <br /> <br /> Each additional branch pkcuit $2.00 <br /> <br />E, Miscellaneous (.%rvice or Feeder Not Included) <br /> Each ptmlp or itrigafi{m circJe $40,00 <br /> Each sign or outli0e Iight/ng t $40.00 <br /> Signal cimuit/$) or a li~[ed energy <br /> panel, alteration or ex~tmsion ~ $40.00 <br /> <br /> Over the alJowabl~ hi any of thc <br /> above, par Inspection ~ $35.00 <br /> <br />O, Minor Instailattan Label~ <br />Pack of lO labels @ SS.O0 each $60,00 <br />(,void anly to electrical contractors) <br /> <br /> ( AS required by Building Official) <br /> <br />~. PR'ES <br /> <br />Al. Enter total of fees from Sec. #4 <br />A2. Add 3% sumharge (.05 x Al) <br /> <br /> $tlbtotal <br /> <br />B, Emer 25% of ~nc A1 for Plan Review <br /> (S~. 3), if mqMr~ <br />C. Inves~gatinnF~ (ffmqui~d) <br /> <br /> ' Y)TAL AMOUNT D~E <br /> <br />Rcaei~ <br /> <br />~2 <br />--2 <br />__2 <br /> 2 <br />__2 <br /> <br />__2 <br />__2 <br />~2 <br /> <br /> <br />