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FOR OFFICE USE ONLY <br />Received by:, <br />Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br /> 220 High Street NE <br /> Salem, Oregon 97301 <br /> <br />Phone ;~1-5147 8:00 ~m - 4:30pm <br />Code~.A.Phone: 588-7904 <br /> F~: 588-7~8 <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete all Sections, I through <br /> <br />I. LO~ATION OFiNSTALLATION <br /> <br />PEP. MiTS ARE NON-TRANSfERABLE AND NON.P~FUNDAB LI{ A.ND <br />EXPIILE 11~ WOPO< IS NOT STARTED W/THIN iS0 DAYS Or ISSUANCE[ <br />OR Il: WORK IS SUSPI!~ND ED FOR 180 DAYS. <br /> <br />gA, CONTRACTOR INSTALLATION ONLY <br /> <br />Probity Owr, cr j Phoa¢ <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br />Property Owner <br /> <br /> Addres~ j Phone <br />Maging <br /> <br />City/~tat¢/Zip <br /> <br />The in~tallat~oa i* being made on property I own wl~d~ i, no~ intended for salc, <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 />required submission of lighting power calculations, plans, <br />and specifications when required by the Oregon Structural <br />Specialty Code, C.l~pter 53. <br /> <br />MC 15-34 11191 <br /> <br />SITE #: <br /> <br />Date: <br /> <br />Permit No. <br /> <br />~TJ~// Issued by: <br /> <br /> 4. ~EE SCHEDUL]g (Complete and eater total in A1 below) <br /> <br /> A. <br /> Unit <br /> <br /> $85.00 ~ <br /> <br /> ~ ~ ~f $15.00 <br /> ~ ~y $~0.00 <br /> E~ M~d ~mc or M~r <br /> <br /> ~. 8er~ or Fe~e~ ~ not ~cu& bnn~ ~rcui~, ~ee s~cuon D) <br /> <br />50.00 <br />~60.00 <br />$~00,00 <br />$~aO,O0 <br />$300.00 <br />$40.00 <br /> <br />$35,00 . 2 <br />$40.00 ...... 2 <br />$80.00 .... 2 <br /> <br />$2.00 <br /> <br />$35.00 <br /> $2.00 <br /> <br />$40.00 <br />$40.00 <br /> <br />$40,00 ........ 2 <br /> <br /> 200 amps or lcss <br /> 201 amps m 400 <br /> 401 amps m 6~0 amps <br /> 601 am~l~,to 1000 amI~ <br /> Ovot I000 araps or voh~ <br /> <br />201 ~raps to 400 amps <br /> <br />a) Th~ fc~ for branch ~mai[s <br /> <br /> over ~* "ll¢'wab]c in any of thc <br /> <br /> ($OM orJy to elzctr&al conzractors) <br /> <br /> ( A~ r:q";rcd by Sullying Official) <br /> <br />$35,00 <br /> <br />$50.00 <br /> <br />Re~i~No, , ,:, .... <br /> <br /> <br />