Laserfiche WebLink
FOR CITY VALIDATION <br />' Recelvcd by: <br /> Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br />COMMUNITY DEVELOPMENT CENTER <br />285 Church St NE · Room 132 <br /> Salemf OR~97301 <br /> <br />ELECTRICAL pERMIT APPLICATION <br />P/ease complete all Sections, 1 through <br /> <br />L LOCATION OF INSTALLATION BUlLI}II~G J/~SPt <br /> <br />D~-"~Iipti°n~ :~ ~.~- ..... -~_~)L(~ <br /> <br /> PERMITS ARE NON-TRANSFERABLE ^ND EXPIRE IP WORK I$ NOT <br /> STARTED WITtlIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPI~IqDED FOR lg0 DAYS, <br /> <br />ZA, CONTRACTOR INSTALLATION ONLY <br /> <br />Mall l' Address <br /> <br />DhOlle <br /> <br />21t, FOR OWNER INSTALLATIONS <br /> <br />3, PI.ANREVIBW SECTION <br /> <br />Marion 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 />PERMIT NO: <br /> <br />Date: <br /> <br />Issued by: <br /> <br />4. FEE $CHI~DULE (Complete and cater tolal in Al below) <br /> <br /> or ~aion fl~of $15,~ <br />~imit¢d Energ7 $2~.~ <br /> <br />201 amps lo 400 amps <br /> <br />601 amps to i000 :naps <br /> <br />a) Thc ['ce fi)f b/'all¢ h cimulm ~j~ <br />Each bnln~ ci~ult <br />b) ~¢ fcc for branch circuits ~j~ <br /> <br /> $cO,00 ~-- <br /> $100.00 -- 2 <br />-. $130,00 --_-- 2 <br /> $300,00 ....... 2 <br /> . $40,00 2 <br /> <br />$35.00 ..... 2 <br />$40,00 2 <br />SaC.co .... z <br /> <br />$ 2.00 <br /> <br />$ 2,00 <br /> <br /> Bach pump or i~igation circle <br /> ~ sign or outline lighting <br /> ~ignal circuit(s) or a limited en*t~y <br /> <br />G. Min~ Instalhtlon Labvls <br /> Pack of 10 labelz ~ $5.00 each <br /> <br /> (~ ~qoired by ~ilding <br /> Aurora Dwelli~ Electrical F~ <br /> <br />$40.00 ..... 2 <br />$40.00 .... 2 <br /> <br />$40.00 .... 2 <br /> <br />$35,00 <br /> <br />$50.00 .... <br /> <br />__~q 1l, x$.05 --.__ <br /> <br />A I, Enter total of fees from Sea, g4 <br /> <br /> Subtotal <br /> <br /> (Sac, 3), if ~quired <br /> <br />D, Rciu~pcct/oa F~ <br /> <br /> 'IOT~ ~OU~ DUE <br /> <br />$ <br />$__ <br />$ <br /> <br /> <br />