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FOR OFFICE USE ONLY <br />Received by: <br />Date: ' ~ <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br /> Salem, Oregc~ 97301 {~ <br /> Phone S88-S147 $:00 ~rn - 4:30pm I'~ <br /> Cede.A-Ph~: g88-7~ <br /> F~: sSS-7~s SITE ~ <br /> <br />1993 Pe..it <br /> <br />[ '~ ELECTRICAL PERMIT APPLIO,ATIQN { ..... Date' MARION <br /> PleaSe :compiet&:~ll:Se'~ions,'3 :tff°ugh5 } :',' ::, :", · ,, ::lssued'by:[[OlLOlN0',' iiN,~SC~ <br /> <br />l,. IXICATIOI~I OF INSTALLATION <br /> <br />Descdpdon, <br /> <br />PERM]TS ARE NON-TRANSFERABLE AND NON-RBPUNDABL{] AND <br />EXP1RB IF WORK IS NOT STARTED W1TH]]k' 180 DAYS OF ISSUANCE <br />OR IP WORK IS SUSPENDBD FOP- 150 DAYS, <br /> <br />FOR OWNER INSTALLATIONS <br /> <br />Owner's Si~mture .. <br /> <br />3. PLAN REVIEW SECTION <br /> <br />We will provide phn review service if you complete Section <br />5B and submit lwo (2) sea of plans and specificmions with <br />this application, <br /> <br /> This optional plan review program doe~ not suspend tho <br /> required submission of lighting power calculations, plans, <br /> and sl~cificatlons when required by thc o gon Structural <br /> Specialty Code, Chapter <br />MC 15-34 11191 " ' <br /> <br />D. Branch ClrolRs <br /> New, Alteration, or Ext~slon Per Panel <br /> <br /> a) Tho f~ fo~ branch d~,YiU ~dl,h <br /> <br /> ~a~h b~ <br /> <br /> F~t b~noh ~rcMt <br /> <br />~ Ml~llan~us (S~vl~ or Fe~ar Not Included) <br /> <br /> ~ si~ or ~e Ugh~ , <br /> ~e~ ~ ~ ~si~ <br />~ ~eh {ddltlen{I I~p~tl~ <br /> <br /> Pack of I0 h~s ~ ~.~ ~ ., <br /> (~o~ o~y to etear~t <br /> <br />H. <br /> ( A~ ~q~red ~ Bu~i~ <br /> <br />$35.00 <br /> $~,00 <br /> <br />$40.00 2 <br />$40.00 2 <br /> <br />$40.00 2 <br /> <br />$35.00 <br />$5o.oo .... <br /> <br />5. FEES <br /> Al, Ymter total of fe~s from Sec~ #4 <br /> A2. Add 5% surcha~c (,0~ x Al) <br /> <br /> B. En~r~% ~hneA1 tor~Review <br /> <br /> D. ~{~m F¢m ($~.~) <br /> <br /> ~TAL AMO~ DUE <br /> <br />Receipt No. <br /> <br />4. FEE SCHEDULE (Comptct¢ ~ e~ter total in A t below) <br /> Number of Inspections p~ permit allowed -~ <br />A. <br /> Residential <br /> Uuit <br /> { <br /> S~l~e Included'. hems Coat (~h) Smut <br /> 1000 sq,/h or les~ $85.00 4 <br /> Bach a~fion~l ~00 sq, ~ <br /> orvo~or km thereof <br /> <br /> Dwelling Sex~ic~ or Fee, der ~ $40.00 ~ 2 <br /> <br />B. $~Iges or Femiers (Does not inlcud~ branch circuits, see s~fi~ D) <br /> ln~lation~ Altar[OhS ~ Rd~$1on ] <br /> <br /> ~ ~ps or less $35,00 2 <br /> <br /> <br />