Laserfiche WebLink
FOR OFFICE USE ONLY <br />Re:eived'by: <br />Date: ' <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br /> 220 High Street NE <br /> Salem, Oregon 97301 <br /> <br />Phone fi88-5147 8:00 am - 4:30pm <br />Cede-A-Phone: 588-7904 <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete all Sections, 1 through <br /> <br />SITE #: <br /> <br />Date: <br /> <br />Issued by: <br /> <br />Permit No, <br /> <br />I, LOCATION OFINSTALLATION <br /> <br />PER. MITS AgE NON-TRANSF~RABLI~ AND NON-REFUiVDABLE AND <br />EX/X~B IF WORK I$ NOT STARTED WTrHIN 1130 DAYS OF ISSUANCE <br />OR IF WORK I$ SUSPENDED FOR 1 S0 DAYS. <br /> <br />CONTRACTOR INffl'ALLATION ONLY <br /> <br /> Owner~ Ph <br /> <br />FOR OWNER INSTALLATIONS <br /> <br />Property Owner <br /> <br />Mailing Address Phone <br />City/State/Zip <br /> <br />The installaffon is being made On ptope~y I own which is nm intended for sale, <br /> <br />Owners Signatum <br /> <br />3- PLAN REVIEW SF, C'rlON <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 pa)gram 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 />4. i~'EE SCHEDULE (Complete and enter total iJ~ A 1 below) <br /> <br /> Number of Inspections per permit allowed <br /> <br />A. <br /> Residential <br /> Per <br /> Ulilt <br /> ! <br /> Service Included: Items Cost (each) Sum <br /> <br /> liXI0 sq. ~- or les~ ~ $88~00 .........4 <br /> Each addlao~al 500 sq, <br /> or portion thereof .... $15.00 <br /> Limi~l Energy $20,00 -- 1 <br /> <br />Each Mamlqd IIome or Modular <br />Dwell/~ Service or Feeder $40,00 <br /> <br />B. Services or Feeders (Does not inlcudc branch ¢ircults, sec ~ection <br /> Installation, Alto. rations or Relocation <br /> 200 amps or less $$0,00 <br /> $60,00 <br /> 201 amps m 400 amps <br /> 401 amp to 600 amps $100.00 <br /> 601amlp61 to 1000 amps $1 S0.00 <br /> Over 1000 amps or volts $300,00 <br /> Reoanncot only __ $40.00 <br /> <br />C. Temporary Servlee.,dFeeders <br /> Installation, AlteratiOn, or Relocation <br /> 200 amps or less __ $35.00 <br /> 201 amps to 400 amps <br /> 401 amps to 600 amps __ $80.00 <br /> Over 600 amps or 1000 volts <br /> <br /> D- Branch Clrcnlts <br /> New, Alteration, or Extension Per Panel <br /> <br /> l~.or~hase of serViCe ot,,feader fee <br /> <br /> Each branch ¢i~uit .... SZ00 <br /> <br /> b) Th6 fee for branch circu[s .without <br /> ,purchase of aery ¢~, or feeder faa <br /> <br /> ~iYSt branch eir clalt <br /> Eae. h additional branch circuit __ Sa,00 <br /> <br />lO. Miscellaneous (Service or Feeder Not Included) <br />Each Immp or [rr~gafic~l circle <br />Each :ign or outlitle light.s <br />Signal circuit(a) or a limited energy <br />panel, alteration or extension $40.00 <br /> <br />F. Each additional Inspection <br />over tho allowabl~ in any of the <br />above, per Inspe¢tion $85,00 <br /> <br />G. Minor Installation Labels <br /> Pack of 10 labels @ $5.00 each <br /> (sold only to eleatrlcal contr~ators) <br /> <br /> II. Other <br /> (As required by Buildigg Official) <br /> <br />5. FEES <br /> Al, En~r tOtal of fee~ fxom Sec. #4 <br /> A2, Add 5% surchargcj (,05 x Al) <br /> <br /> Subtotal <br /> <br /> B. Ent, r 25% of line Al for Plan Review <br /> (Sec. 3). if required <br /> C. Investigation Fee (if required) <br /> D- Reinspeclion Fee ($25,00) <br /> <br /> TOTAL AMOUNT DUE <br /> <br /> <br />