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......... MARION COUNTY BUILDING INSPECTION <br /> <br /> Received by. 285 Chinch St, NE - Room I32 x~ -~ .~ ~ ~,..~d <br /> Date: . a-, . S~lem, O~go~ 9730~ ~ % ~ <br /> <br /> ELECTRICALPERMITAPPLIGATION Date: ~-, ' /p/tit <br /> ......... ., <br /> <br />pERMrI$ ARE NON-TRANSFERABLE AND NON.REFUNDABLE AND <br />EXPIRE IF WORK IS NOT STARTED WITHIN 180 DAYS OF ~$SUANCE <br />OR IF WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />2A, CONTRACTOR INSTALLATION ONLY <br /> <br />Contraetogs License <br /> <br />Signamm of Illl~ ~et rieian <br /> <br />Job No. <br /> <br />Phouu No- <br /> <br />2B, FOR OWNER INSTALLATIONS <br /> <br />Progeny Owner <br /> <br />Mailing Address Phone <br /> <br />City/St ara/Zip <br /> <br />leag¢~ Or r~nt. <br /> <br />3, PLAN REVIEW SECTION <br /> <br />We will provide plan rev/ow service if you complete Section <br />5B and submit two (2) sets of plans and specifications with <br />this application. <br /> <br />Tiffs optional pVm review program does not suspend thc <br />requirex! submission Of lighting power calcnladons, plans, <br />and spccfficafions when required by the Oregon Structural <br />Specialty Ccxlc, Chapter 53. <br /> <br />MC i5-34 8/94 <br /> <br />lO00 sq, ~ or less ~ $85.00 <br />]~ach uddi~mual $00 sq. fi, <br />or porfi~ thereof $15,00 <br />[MM~ed Energy '~ $20,O0 <br />Each Manu£d Home or Modular <br />Dwelling Senfce of Fe~der $40.00 <br /> <br /> 200 amps Or less SgO,O0 <br /> 201 amps to 400 amps $60,00 <br /> 401 am~ to 600,~np* <br /> 601 amps to 1000 amps $180,00 <br /> Over 1000 amps or volts ....... $300,00 <br /> Reo0nn~c~ only <br /> <br />C. Temgorary Servlces/Ft~ders <br /> <br /> 201 ~np~ to 400 amp~ <br /> 401 ampa tO 600 am~ <br /> <br />D. Rranch Circuits <br /> <br /> &) The fee for branch c~'gnit~ with <br /> gurcham of sqrdcc or ~e-~r fee <br /> <br /> Each brach ~rc~t ~ $2.00 <br /> <br /> ~r~e of sc~ or f~r <br /> <br /> F~t branch ~im~t $38,00 <br /> Each ~6ifim~ bmn~ 6r~it $2.~ <br /> <br />E. Miscellanies (Servl~ 0r Peeder Not Included) <br /> <br /> Each ai~ or ou~¢ <br /> Signal c~la(s) or a ~md <br /> ~fl~, al~mfi~ <br /> <br />~. ~ch ~dRionat <br />~er ~e ~able <br />a~ve. ~ ~s~c~on $35.00 <br /> <br />G. Minor lns~llation ~bels <br />Pack of I0 la~l$ ~ $5,00 ea~ $~,00 <br />(sold o~y to ~l~atr~al contmctor~) <br /> <br /> ( AS ~qMred ~ Building Offic~l) <br /> <br />5. FEES <br /> Al, Enter total of fees from Sec, #4 <br /> A~. Add 5% surcharge 605 x Al) <br /> <br /> Subtotal <br /> <br /> B- Enter 25% of [[ne Al for Plan Revi~ <br /> (Se~. 3), if reqlhred <br /> C. investigationFee (Lt' roqulred) <br /> D. Reinspectlon Fee <br /> <br /> TOTAL AMOUNT DUE <br /> <br /> Receipt NO, ,,,, <br /> <br /> <br />