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eived by:_ <br /> <br /> MARION COUNTY BUILDING INSPECTION <br /> 220 High Six,et NE <br /> Salem, Oregon 97301 <br /> <br /> Phone 58g-5147 8:00 ~ - 4G0pm <br /> Cede-A-Phone: f88 -7904 <br /> r,~: 5ss-?94s SITE #: <br />ELECTRICAL PERMIT APPLICATION { Date: <br />Please complete all Sections, 1 through 5} Issued by: <br /> <br />PEP. MITS ARE NON-TRANSFERABLE AND NON-REFUNDABLE A/qD <br />EXPIRE IF WORK IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE <br />OR IF WOP. K IS SUSPE~DED I~OR 1 S0 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br />Electrical Contractor <br /> <br />Mailing <br /> <br />Pml~rty Owner <br /> <br />Contractor's Lie. m se No. <br /> <br />Contra~or's Board R~g. NO, <br /> <br />Su~isoF~ Li~n~a No. <br /> <br />Phone <br /> <br />ISob No. <br /> <br /> No. <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br /> he xnal~aa~ Is ~mg mad~ ~ pm~ I ~n w~ch i$ a~ ~M for <br /> <br />3- PLAN RgVIEW 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, Chapter 53. <br /> <br />MC 15-34 Ill91 <br /> <br />4. FEE SCHEDULE (Complete and enter to~l ~n A1 below) <br /> <br /> Numbe~ of Inspections per permit allowed <br /> <br />A. <br /> R~identtal <br /> Per <br /> Unit <br /> SerVice Included: he~s Cost (each) Smn/ <br /> <br />1000 sq. f% or less $85,00 ~ <br />Each additlollal 5130 sq. fl, <br />~¢ pO~O~ thereof -- $15,00 <br />Limited Ermg[ ~ $20,00 -- <br />Each Manofd Him~¢ or MofluiLar <br /> <br />~, Ser~lee~ or Feeders (Docs no{ inlo~d¢ branch circuhs, sec scedon <br /> <br /> 200 amp~ or less ~ $S0,00 <br /> 201 amps to 400 ~nlps $60.00 <br /> ~01 arnp~ to 600 amps $~00.00 <br /> 601 amW to 1000 mnp~ $;30,00 .... <br /> Over 1000 amps or volts ~ $800.00 <br /> Reconnect only $40,00 <br /> <br />C. Temporary Servlcet~F~a~rs <br /> <br /> 201 ~ps to <br /> 401 ~p$ to <br /> <br /> Each ~mp ~ ~gafi~ ~rde <br /> <br /> S~n~ ~og(s) or a ~ted an~y <br /> <br /> ~er ~e a~owabl¢ <br /> <br /> Pack ~ 10 la~ <br /> <br /> ( n~ ~q~r~d by Buildi~ Offlcal) <br /> <br />~. FEES <br /> <br /> A2. Adg 5% suraha~a (,05 x Al) <br /> <br />$35,00 <br />$40.00 <br />$80.00 <br /> <br />$3S.00 <br /> $2.00 <br /> <br />$40.00 2 <br />$40,00 2 <br /> <br />$40.00 ~ <br /> <br />$35.00 <br /> <br />$50,00 <br /> <br />Receipt No. <br /> <br />$ <br /> <br /> <br />