Laserfiche WebLink
~FOR OFFICE USE ONLY <br /> Receive~ by:. <br /> Date: ...... <br /> <br />Phon~ 588-5147 S:O0 :au - 4:30pm <br />Code~A.P'nor~: 588-7904 <br /> FAX= 588-7948 <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br /> Salem, Oregon 97301 <br /> <br /> 0 <br /> <br /> ELECTRICAL PERMIT APPLICATION <br />I Ple..a.~.e. complete all Sections, 1 throu..gh 5 <br /> <br />1. LOCATION OF INSTALLATION <br /> <br /> I <br />Dimmings <br /> <br />DescriptiOn <br /> <br />PERMITS ARE NON-TRANSFERABLE AN~ NON-RI~FUNDABLE AND <br />EXPIRE IF WORK 13 NOT ~TARTED WITHIN lC0 DAYS OF IgSUANCE <br />OR I1: WOKK IS SUSPENDED FOR 180 DAYS. <br /> <br />2B, FOR O~rNER INS~TALLATIONS <br />Prol~ny Owner <br />Mailing Address Pl~one <br />City/State/Zip <br /> <br />The instalhfion is being made on psopeny I own which is nc~ intended for sale. <br /> <br />3. PLAN REVIEW SECT/ON <br /> <br />We will provide plan review .~rvice if you complete Section <br />5B and submit two (2) sct~ of plans and specifications with <br />this application. <br /> <br /> This optional plan reviow 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 11/92 <br /> <br /> Date' M~Om~, ..... <br /> ~UILUING INgP~nvm~, <br /> ssuea Dy. . ' ~, <br /> <br />A, <br /> ~d~tl~ <br /> Unlt <br /> I <br /> 1~ sq, f~ ~ ~ss $~,00 ,,, 4 <br /> E~h ad~fi~ 5~ sq, R, <br /> ~ ~ ~mof $15,00 <br /> ~d En~gy $~,00 1 <br /> Each M~d H~c or M~uhr <br /> Dw~ Sc~ ~ F~ $40.00 ~ 2 <br /> <br /> 200 amps ~ less <br /> 201 am~ to 400 ampa <br /> 401 aml~ to C~0 amps <br /> 601 amp~ to 1000 arnps <br /> Over 1000 mnps or <br /> <br />C. Temporar~ Servlces~eeaers <br /> <br /> 200 amps ot less <br /> 201 amps to 400 amp~ <br /> 401 amps to 600 amps <br /> Over 600 amps or 10~0 volts <br /> <br />D. ge~me# Circuits <br /> New, Alteration, or Extension Per Panel <br /> <br /> a) The fee for branch dtoait~ ~th <br /> <br /> ~ach Imanch c~cu~t <br /> <br /> b) The f~ foe blanch clrcuts w/thqut <br /> <br /> First br~nch circuit <br /> Each addiSonal bra~ch circuit <br /> <br />E. MiscellaneOUS (S~rvle~ or F~ler Not Included) <br /> Each pump or in/gat/c~ circle <br /> Each ~isn or outline l/ElY, lng <br /> ~ignal eir~uiffs) or a limited energy <br /> pand, almradon or extrusion <br /> <br />F. E~R add[tinnal Ins~neo <br /> over the allowable in any <br /> above, ~ Inspection <br /> <br />G. Minor Imtalinlinn L~be~s <br /> Pack of 10 labels @ $5,00 e,~ch <br /> (~old only to ¢lectric~l ¢ontractom) <br /> <br />H. Other <br /> ( A~ required by l}uildlng Offi¢~a0 <br /> <br /> ~50.00 __ 2 <br /> 60,00 2 <br />$1oo.oo 2 <br />$13o.oo 2 <br />$300,00 __ 2 <br />$40,00 __ 2 <br /> <br />$35.00 2 <br />$40.00 __2 <br />$80.00 __2 <br /> <br />$2.00 <br /> <br />$ s.oo <br /> $2.00 <br /> <br />$40.00 <br />$40,00 <br /> <br />$40,00 2 <br /> <br />$~5,00 <br /> <br />$~o,oo <br /> <br />$. FEES <br /> Al, Eater to~d of fee~ from $~c~ #4 <br /> A~, Add ~qo surcharge (,05 xAI) <br /> <br /> Subw~l <br /> <br /> B, Enmt~%of~Al for~nRe~ew <br /> ~, 3), ff ~ <br /> <br /> ~TAL ~0~ DUE <br /> <br /> <br />