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FOR CITY VALIDATION <br />Receive. d by:,,, <br />Dater <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete all Sections, i through <br /> <br />MARION COUNTY BUILDING INSPI~CTIOlhL.. ~._~,,~/-'. ,- <br /> <br /> BUILDING <br /> <br /> 4. ~ SCHgD~ {Complete all0 ¢nl~ loml hi Al bcl0w) <br /> Unit <br /> <br /> PERMITS ARE NON-TRANSFERABLE AND EXPIRE lle WORK IS NOT <br /> STARTED WITHIN 180 DAYS OF ISSUANCE OR <br /> WORK Is SUSPENDED FOR. IRQ DAYS, <br /> <br />2A. CONTRACTOR INSTALLATION OlffLY j <br /> <br /> 2B. FOR OWNttR INSTALLATIONS <br /> <br /> Property Owner (j)lcaso print) <br /> IVhtiling Addreaa __ / Phone <br /> City/State/Z¥ <br /> <br />3. PLAN RRViEW Si~iCTION <br /> <br /> Marioo County does not require a plan review, <br /> We will provide plan review service if you complete <br /> Section 5B and submit two (2) sets of plans and <br /> specifications with this application. <br /> <br />MC I,%34 <br /> <br />200 umm or le~s ~ <br />20} emps to ~00 ~mpa <br /> <br />601 atn~ to 1000 mnps <br /> <br /> a) ~e 1}* for brach c~ui~ ~ <br /> <br /> b) ~e fee Iht brunch cimoits ~ <br /> <br /> ~ch additional brmeh eh~it <br /> <br />~aeh additlon=l lnap~tion <br /> Owr thc allowable i~ gay of ~e <br /> <br /> Pack of 10 lnb~h ~ $5.~ ~auh <br /> <br /> {~ r~¢tfircd by ~dldi~ O~ebO <br /> Aurora ~elling ~lect~eal ~ <br /> Dw~aiag Pcm~it ~1 <br /> <br />$69.00 <br />$100,00 <br />,%130,00 <br />$3(Xi.00 <br />$40.00 <br /> <br />$351D ~__2 <br /> <br />$~.~ .... 2 <br /> <br />$ 2.00 -- <br /> <br />$35.6(I <br />$ 2.9O <br /> <br />$40,00 ~-- 2 <br /> <br />~.00 ---- 2 <br /> <br />$35.00 -- <br /> <br />$50.00 <br /> <br />sq./L x $.06 =__ <br /> <br />FEES <br />A I. EntEr total of fees from S~. #4 <br />A2, AddS% surchaeg¢ (,05 xAI) <br /> <br /> TOTAL AMOUNT DUE <br /> <br /> <br />