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" ' MARION COUNTY BUI~LDING INSPECTION <br />FOR, OFFICE USE ONLY <br />I Received by: 220High ,qtreet NE <br /> <br /> , ....... ~ ~% . PAX: 555-7948 ~ '~ OHI;: ~"~il~ll~ma~ <br /> <br />[ Please ~omplete.all Sections, 1 through 5 I ~AR~ON GOUflI¥ issue <br /> <br /> 1. LOCATION OF INSTALLATION 4. F~E $CHEDUL1 <br /> <br />pERMrFS ARE NON-TRANSFERABLE AND NON-REPUNDABLE AND <br />I~XPIRE IF WORK IS NOT STARTED WY£HIN 180 DAYS OF ISSUANCE <br />OR IF WORK IS SUSPIh'qDED FOR ! S0 DAYS, <br /> <br />FOR OWNER INSTALLATIONS <br />proper~ Owaer <br />_M.~ng Addr~ Phone <br /> <br />PLAN REVIEW SECTION <br /> <br /> We will provide plan review ~er~ic~ if you ~omplel~: 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 specifical/ons when required by the Oregon Structural <br /> Specialty Code, Chapter 53. <br /> <br />MC 15-34 11/91 <br /> <br />A. R~ld~tlal Per 1 <br /> <br /> t <br /> ~ ~m ~o Reques ed b~~ <br /> <br /> Dw~ Se~ - <br /> <br />B. Servl~s or Feeders ~S hot ~l~d~ ~nch tire,ts, see secfi~ D) <br /> Ins~ia~on, Al~rations or R~atlon <br /> <br /> 200 amps or less $$0.OO <br /> ~ol ~ ~4oo~p~ /.':" $~0,00 <br /> 401 ~a'nps to 600 amps $100.00 <br /> 601 amps m 1~00 am[~ $130,00 <br /> Owr,1000 anps or voh~ $300,00 <br /> Reo3nnect ot~ly $40,00 <br /> <br />C. Tempoeary Servlces/~eeders <br />InStallation, AIt~-atlon, or Relo~atlon <br />200 amps or less .,. $35.00 <br />g01 amps m 400 am~ $40,00 <br />401 arags to 600 amps $80,00 <br />Over 600 amps or I000 volts <br /> <br />D. Stanch Clrcujt~ <br /> ' New, Alteratlon, orExten~lonPerPanel <br /> <br /> a) The f~ for branch {~rcults ~th <br /> <br /> b) The f~ for branch drmts <br /> <br /> Fire branch ~/~cn~t <br /> ~ach additional branch clrouit ... <br /> <br /> ' ".F~ichpump otirrlsat~m circle _. $40.00 <br /> <br /> over the allowable in any of the <br /> show, l~r ]hspect~on $35,00 <br /> <br /> Pack of tO lsbels ~ $5,1XI e~e.h $50.00 <br /> (*old only to ,/eetrical <br /> <br />ti. Other' <br /> ( A.* req,,;red by Building Offi¢inO <br /> <br />5. <br /> Al. Fat~r total of fees from $~c. #4 <br /> A2, Add~%surcharg~(,0SxA1) $ ~ <br /> <br /> Subtotal <br /> <br /> (sec. 3). il r~qalr~l $ ... <br /> ¢. lnw, t~atlon F~ (if ~qak*d) $. <br /> D, Reimpo3ti~q Fee ($25.00) $ <br /> <br /> TOTAL*MOUNT DUE <br /> <br />R,¢eipt No. ., <br /> <br /> <br />