Laserfiche WebLink
FOR OFFICE USE ONLY <br />Received by: <br />Date: <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete all Sections, I through 5 <br /> <br /> °220 High Street NE <br /> Salem, Oregon 97301 <br /> <br />Phone 58~.5147 8:00 sm - 4:30pm <br /> Cod~-A=Phone: 5S8-7904 ,~,. <br /> lAX: 555-7948 <br /> <br />MARION COUNTY.BUiLDING INSPECTION <br /> <br /> TE #: R '~it No, <br /> <br />PRRMIT$ ARE NON-TRA-NSFERABLE AND NON-REFUNDABLE AND <br />EXPIRE IF WORK IS NO/' STARTED WITHIN 150 DAYS OF ISSUANCE <br />OR IF WORK IS SUSPENDED FOR 180 DAYS, <br /> <br /> FOR OWNER IN~ALLATION8 <br /> <br />P~ Owner <br /> <br />Marlins Address Phone <br />City~tate/Zip <br /> <br />Thc installation is b~ing made on property I own which is mx in.'reded for <br /> <br />Owner's Signatu~, <br /> <br />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 thc <br />required submission of lighting power calculations, plans, <br />and specifications when required by thc Oregon Samctural <br />Specialty Code, Chapter 53. <br /> <br />MC 15-34 ]I/91 <br /> <br />4. FEE SCHEDULE (Ca~nplete and enter total in A 1 below) <br /> <br /> Number of Inspections per permit <br /> <br />A. <br /> Resldentlal <br /> Per <br /> Service Ineludedt It.s Cost (each) <br /> <br /> 10~ sq. k ~ less $85,00 <br /> Eac~ a~i~d 5~ a~. n, <br /> or ~M~ ~hercof $15.O0 <br /> L~i[ed ~ncmy ~ $20.00 <br /> Each Manufd Hmo or M~ular <br /> Dwe~ng ge~ or Feeder $40,00 <br /> <br /> ~ m~ or less $50.00 <br /> $60.~ <br /> <br /> ~1 am~ ~ 1{~0 amps $~$~.00 <br /> ~er 1~ ~ps or volts <br /> Rc~I ~lly $40.00 <br /> <br /> ~ amps or less ~ <br /> 201 ~p~ to ~0 amps $40.00 <br /> 401 amps to ~ ~p~ ..... <br /> ~e~,~ ~p: or 10~ vol~ <br /> <br /> ~ha~c of E~i~ or fc~er <br /> Bach brmch circuit ~ $2.00 <br /> <br /> b} The f~ f~ branch dmu[s ~ <br /> p~q~ne of ~ ~,e 9~ feeder fee <br /> <br /> F~t bmn~ ~rCuJt $35.00 <br /> Each a~d~fl~al b~n~ o~u~t <br /> <br />E. M~lla~us (Servl~ or Feeder Not ]neluded) <br /> Each ~mp ~ imgaa~ clinic $40.00 <br /> ~¢h sign or outline [ightkng , $40 <br /> Signal ¢~ecuit(s) or a h~ted <br /> <br />E Each additional Insp~tion <br /> ~er ~e aB~able M any of ~e <br /> a~, per ~ec~n <br /> <br /> Paak ~ 10 la~ ~ $5,00 ea~ $S0.00 <br /> (sold onl~ to electrical comr~tors) <br /> <br />H, Other <br /> ( A~ mqulred by Buildins Offla~O <br /> <br />5. FEES <br /> <br /> Al. <br /> gnter total of t%,~s from Sec. #4 <br /> A2, Add 5% sumharge (.05 x A I) <br /> <br /> Subtotal <br /> <br /> B. BnU:r 25% of llne A1 for I~rt Review <br /> (Sec. 3), if t~qulred <br /> C- Investigation l~¢e' (ff required) <br /> D. Reinspection Fee ($25.00) <br /> <br /> TOTAL AMOUNT DUg <br /> <br />Receipt No. ~ <br /> <br /> <br />