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[ 'oa omc OSL¥] <br />[ Rece!ved by: <br /> I <br /> <br />MARION COUNTY.BUILDING INSPECTION <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete all Sections, I through 5 <br /> <br /> 1, ~TION OFIN~AL~TION <br /> <br />PERMITS ARE NON-TRANSFER~B LB AND NON-REFUNDABI.t[ AND <br />E,'~alRE IF WORK IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE <br /> <br />2II. FOR OWNER INSTALLATIONS <br /> <br />PmperW Owner <br /> <br />The installation is being made on property I own which is no~ intended for sale, <br /> <br />Owner's Signature <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 Sl:ecdications with <br />thin application. <br /> <br /> 220 High Street NE .. <br /> Salem, Oregom97301 <br /> <br />Phone 588-5147 8:00 am - 4:30pm <br />Coda-A-Phone: 588-7904 <br />tAX: $ll8-7948 <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 III9I <br /> <br /> S[~,~: Permil NO. <br /> Date: <br /> Issued by~RiON,, <br /> BLIILI)~NB NS'~(T7 ( ~'~ <br />4. ~ SCH~D~E (tinplate ~d enter ~l ~ A 1 ~inw) <br /> <br />A. R~ldentlal Per Unit <br /> Service Included: <br /> <br />Each a~dig, ona1500 vt. ft, <br />o~ poe. ieu ,.hereof <br /> <br />$85.00 4 <br />$15.00 <br /> <br />Each Manufd Hom~ or Modular <br /> Dwellhng S~rvice or Feeder <br /> <br />$20.00 -- 1 <br /> <br />$40.00 <br /> <br />Scrvlce~ or Feeders (Does no/inlcude branch c~ rcuit% see secdon D) <br />Inatallatlon~ Alterations or Rc4oeatlon <br /> 200 aml~ or lcs~ $50.00 <br /> 201 aml~ ~o 400 amps $613.00 <br /> 401 aml~ to 600 amps __ $100.00 --. 2 <br /> (~01 am~gg)to 1000 amps $180.00 2 <br /> Over 1000 amps or voR~ $300,00 -- 2 <br /> Rocormcm only $40.00 -- 2 <br /> <br />200 amps or leis $35,00 <br />201 amps to 400 amps $40.00 <br />401 afl, pi to O~0 nmp~ $80,00 <br /> <br />a) The fee for branch circuits w{th <br /> purchase 9f ~rv/ce or f~eder fee <br /> <br /> 'Each branch elxeuit <br /> <br />b) The fee for branch cireut~ without <br /> <br /> Each sign or ~ullinc ~$hti~g <br /> <br /> ( AS r~qMr~d by Building Official} <br /> <br />$2,00 <br /> <br />$S5.00 ~ <br />$2,00 <br /> <br />$40.00 <br />$40.00 --2 <br /> <br />$40,00 <br /> <br />$35.00 <br /> <br />Sso.oo <br /> <br />5. FEES <br /> <br /> A I- ]~t~r to~al of fee~ from Sec. #4 <br /> AZ, Add 5% samharge (,05 x Al) <br /> <br /> Subsoil <br /> <br /> B. Enmr ~% of ~a* A 1 for Plan ~viaw <br /> (S~. 3), if mq~r~ <br /> C. ~v~tigafi~ F~ (ff~ff~d) <br /> D, Re~s~fi~ F~ ~) <br /> <br /> toTAL ~0~ DU~ <br /> <br />$ <br />$ <br /> <br />Receipt No. <br /> <br /> <br />