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FOR OFFICE use 'ONLY <br />Received by: <br />Date: ~ <br /> <br />Phone 588-5147,8:00 am - a:30pm <br />Code-A-Phone: 588-7904 <br /> FAX: 588-7948 <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br />' ELECTRICAL PERMIT APPLICATION <br /> Please complete all Sections, 1 through 5 <br /> <br />1. LOCATION OFINSTALI~TION <br /> <br /> I <br />I I EX3PIP. E IF WORK IS NOT STARTED WITI-1IN IS0 DAYS OF ISSUANCE <br /> ] OR IF WORK IS SUSPENDED FOR 180 DAYS. ,, , <br /> <br />,r ~croa ~..NSrA,~LA~[ON ONL~ ~ _ <br /> / E~tri~al Co~ "- '"'~'~""' ~ Phon~ ' -- '~ <br /> <br />::' <br /> <br /> ,3,~; FOR O~'iNgr,~,~TlO~$ <br /> <br />Malling Address Phone <br />City/State/Zip <br /> <br />PLAN REVIEW SF~TION <br /> <br /> We will proyide plan review service if you complete Section <br /> 51t and submit two (2) sets of plans' and specificatiOnS With <br /> this application. <br /> <br />This optional plan review program docs 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 /> Date: t~A ..... ~'.,,u u ~,~7¥ ........ <br /> ~ssued ~./LD. IN6 INSpE~TInN <br /> <br /> 4. FEE SCHEDULE (Complete m~d e'amr toh~l in Al below) <br /> <br />/'"""~ N{~ml~r Of t~speetlons per pemlt allowed <br /> <br />A. l~estdenflal Per Unlt <br />,:: :, :?ervlce Indufled: Itoi*ls Cost(each) Sum/ <br />I000 sq. fL or less $85.00 __ <br />Each additional 500 sq. fi. <br />or posen inemof $16.00 <br />Limiu:d En¢i'gy $20.00 ~ <br /> <br /> Dwcl[|ng Servioe or Feeder . $40.00 __ <br /> <br /> InstallatiO#~ Alterations or R~10eation <br /> 200 amt~ or l~ss : , $50,00 <br /> 201 amps to 400 amps $60,00 <br /> <br /> C., TempOrary ServleegFeeders . <br /> <br />--~--l~er 600 amps ~ 1000 volts <br /> <br /> ~ur~has~,of :emlm <br /> Each broach ~%'a~ <br /> Tho fe~ for brarte, h ~ <br /> <br />$100,00 __ 2 <br />$130,00 2 <br />$300,00 __2 <br />$40,00 __ 2 <br /> <br />~35.00 2 <br />40.00 2 <br />$80.00 2 <br /> <br />New, Alteration, or Extension l~er Panel <br /> <br />a) The f~ fro- branch ~[rctl/ts2/iih <br /> ~u~ha~,~ :c~ or fe~er f~, <br /> <br /> $2.~ <br /> <br />b) ~ f~ f~ bm~ ~mt* ~out <br />~e of ~c~ce ~ feedq~,~ee <br /> <br /> Each ~difion~ bm~ ~c~t $2,00 <br /> <br /> Signal circuit(s) or a ] <br /> <br /> Each addaiona! Inspection <br /> over thc allowable in any of the <br /> above, let Insi~etion <br /> <br />G. Mtnor Installation Labels <br /> Pack of 10 labela@ $5.00 ~ae, h <br /> (sold only to electrical ¢ontraetom) <br /> <br />H, Other <br /> ( Ac required by Buildlng Offi¢ia0 <br /> <br />$. FEES <br /> Al. Enter re{al of fee~ from $~¢. #4 <br /> A2. Add 5% surcharge (-05 x Al) <br /> <br /> Subtotal <br /> <br /> E. Enter 2,5% of lineAl for Plan Review <br /> (Sec. ~), if <br /> C, InvestigationFee (ffmquired) <br /> D. Reinspecfica Fee <br /> <br /> TOTAL AMOUNT DUE <br /> <br />~ $40.00 2 <br /> <br />$35,00 <br /> <br />$50.00 <br /> <br />$ 4 .oo <br /> <br /> <br />