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MARION COUNTY BUILDING INSPECTION <br />FOR OFFICE USE ONLY <br />Received by: 220 High S~xoet NE <br />Date: Sale~% Oregon 97301 <br /> <br /> ELECTRICAL PERMIT APPLICATION <br /> Please complete all Sections, I through 5 <br /> <br />PERMitS AR}~ ~ON-TRA2qSFERA~E A~qI) NON-I~FUNI)ARLE A]~ <br />~XPIRE IF WORK tS NOT START!RD ~ 1 $0 DAYS OF ISSUANCR <br />OR IF WORK IS SUSFENDED FOR l $0 DAYS. <br /> <br />CONTRACTOR INSTALLATION ONLY <br /> <br />2g FOR OWNER INSWALI,ATIONS <br /> <br />Property Ownor <br /> <br />City/State/7~p <br /> <br />TI~e ineatlat~on is being made on property I own which is n~ int~r~l~t for sale, <br /> <br />Ownm/$ Signature ...... <br /> <br />3. PLAN REVIEW SI~CTION <br /> <br /> We will provide plan review service if you comple~ Section <br /> 5B and submit two (2) gets of plang and specifications with <br /> this application. <br /> <br />This optional plan review program does not suspend the <br />required submiss/on of lighting power calculations, plans, <br />and specifications when required by the Oregon Structural <br />Specialty Code, Chapter 53, <br /> <br />MC 15-34 11/91 <br /> <br /> issued by: <br />.....m UNI~ * ,.e~ '~ .... ,~-., <br /> <br /> Number of [nspecthms p~- permit allowed --~ <br /> <br />A. <br /> Residential <br /> Per <br /> Unit <br /> / <br /> Service Included: Items C~[ (each) Sum/ <br /> <br /> 1000 sq. fl or less ~ $85,00 -- 4 <br /> Each additional 500 s~. ft. <br /> or cdoo thereof ..... <br /> IAmi~ne~gy . $20.00 <br /> E~h Manugd Home or M~dular / ~-.~2 <br /> Dwelling Sev,4c~ or Feeder $40.00 <br /> <br />B* Servh:es or FoOder~ 0~s not in]cnde branch C~rcults, see section D) <br /> Installation, Alterations or Relocation <br /> <br /> 200 amps or l~ss $$60,00 2 <br /> 201 am~ to 400 ~-np$ __ 2 <br /> 401 amps to 600 amps $ I00.00 2 <br /> fiOl amps to 1000 am~ $180.00 __ 2 <br /> O~er 1000 amps or volts $300.00 2 <br /> Re. connect o~ly $40,00 -- 2 <br /> <br />C, Temperary <br /> <br /> 200 amps or l~ss ~ $35,00 -- 2 <br /> 201 ~ to 400 art~ ~ $40,00 <br /> 401 a~llps lo 6,00 amps ~ $80,00 __ 2 <br /> <br />D. Branch Circuits <br /> <br /> a)Th¢ f~ fcc branch ~ireuits with <br /> nurchase..o{ se~vlca or feed¢.r <br /> <br /> Each Immch clrcui~ ~ $2,00 <br /> b) TI~ fe~ fo~ br ~e.~ ~l~mS witl~Ou~r <br /> <br /> First br~nch cimdit $85.00 <br /> ~ additional branch circ,,;t <br /> <br />E, Mlseellantn}us ($ervlo~ ov Peeaer Not Ineluded) <br /> Each pump or irrigation ~r~le $40.00 __ <br /> Each s~gn or ootline lighting __ $40.00 -- 2 <br /> Signal circuit(s) or a limited energy <br /> <br />F, l~ach addlttonsl Inspection <br />ov:r ~le allowabl~ in any of the <br />above, p~r Iml~ectlon ~ $$$.00 <br /> <br />O. Minor InStallation <br />Pack eft 10 label~ @ $5.00 ~ach ~ $,50,00 <br />{~old only to eleetr~al contraetom) <br /> <br />H, Other <br /> ( As mq~ired by Building Offldal) <br /> <br />$, FEES <br /> <br /> A2. Add 5% (,05 Al) <br /> Subtotal $ <br /> <br /> B.Enter 25% of lin* A1 for Plan Review <br /> (Sec. 3), if required <br /> C, hvutigafion~ ~ ~q~ima) <br /> D. R~in~pe~ ~ee ($~.00) <br /> <br /> TOTAL ^MoUN'T DUE <br /> <br /> Receipt No. ,, ,,, <br /> <br /> <br />