Laserfiche WebLink
[I~OR OFFICE USE ONLY <br /> Received by:, <br /> Date: <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete ail Sections, I through 5 <br /> <br /> ,. o,,,,,,..,.,.,.,.o,, %4/-¢-:-: <br /> <br /> Dir~¢ons I <br /> <br />i MARION COUNTY BUILDING INSPECTION ~ <br /> salem, Oregon 97301 ~ <br /> Phone 588-5147 8:00 ara - 4:30pm <br /> ,, PAX: ~Ss.7~48 SITE #: <br /> Date: .. MAR~0N cOUb!TY <br /> Issued by: BUILDING INSPEOIION <br /> <br />PF..RMIT$ ARE NON-TRANSFERABLE AND NON-I~FUNDABLE AND ;: <br />EXPIRE IF WORK IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE , <br />OR IF WORK IS SUSPENDED FOR 180 DAYS. ': <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />Ptx~w~ Owner <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br />Mailing Address Phon~ <br />City/~tatc/ZJp , <br /> <br />Thc installation is be&ag made on prop*try I own which is not inl~nd~t for ~ <br /> <br />Own¢¢s Signature .... <br /> <br />3. PLAN REVIEW SECTION <br /> <br /> We will provide plan review service if you complete Section <br /> 5B and submit two (2) sets of phns and specifications with <br /> this application. <br /> <br /> This optional plan review program does not suspend the <br /> requieod submission of lighting power calculations, plans, <br /> and specifications when required by the Oregon Stmcnlral <br /> Specialty Code, Chapter 53. <br />15-34 1]/91 ' <br /> <br />4. FEE SCHEDULE (Complete and cnt6r total in A1 below) <br /> Number of Inspections pot permit allowed -~ <br />A, <br /> Residential <br /> Per <br /> IJnlt <br /> / <br /> Service Included: Ite4~s Cost (eech) Sore/ <br /> 1~ sq, fc¢ I~ss $85.00 4 <br /> <br />~ ~n~y $20,00 1 <br />g~ ~n~d ~e or M~u~ <br />Dwe~ ~ o~ Feeder $40,00 2 <br /> <br />In~llaUon, Alterations or R~locaflon <br />gOO amps or less <br /> <br />~r 1~ ~pS Or <br /> <br />~1 ~ps to ~ <br /> <br /> ~t branch &c~t <br /> <br /> ( ~ ~red 5y <br /> <br /> eso,0o .~¢~ 2 <br /> 60,00 2 <br />$~00.00 2 <br />$130,0~ ~2 <br />$300,00 ~ 2 <br />$40,00 2 <br /> <br />$35.00 =,, 2 <br />$40.00 2 <br />$80,00 2 <br /> <br />$35,00 <br /> $2.00 <br /> <br />$40,00 <br />$40,0O <br /> <br />$40.00 2 <br /> <br />$35.00 <br /> <br />$50.00 <br /> <br />A l, ]Enter total of fccs from Sec. #4 <br />A2, Add 5% sumhalg~ (,05 x <br /> <br />B, E~r ~5% of ~ne A1 for Plan ~evicw <br /> <br />D, Re~s~l Fee ($~,00) <br /> <br /> TOTAL AMOUNT DUE <br /> <br /> <br />