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MARION COUNTY BUILDING INSPI3,CTION <br /> <br />COMMUNITY DEVELOPMENT CENTER <br />285 Church St NE · Room 132 <br /> Salem, OR 97301 <br /> <br />FOR CITY VALIDATION <br />Received by: <br />Date: 24 Hr Inspeetloa Line: 588-7904 <br /> <br />Please complete all Sections, I through 5 <br /> MARION <br /> <br />PERMIT NO: <br /> <br />Date: <br /> <br />Issued by: <br /> <br />(Complete and eater total in Al below) <br /> <br />7Al_ FOR OWNER IINSTALLATIONS <br />properly Owner (ploase print) <br /> <br />Mailing Address { Phone <br /> <br /> City/State/Zip <br /> <br />3. PLANRBVIEW SBCTION <br /> <br /> Marion County does not require a plan review. <br />We will provide plan.review service if you complete <br />Section 5 B and submtt two (2) sets of plans and <br />[..specH]cations with this application. <br />MC 1.5-.)4 <br /> <br /> $85.00 ~4 <br />Eaeh additional 500 sq. ft. <br /> <br />Limited F~(~etg y $20.00 1 <br />F. ach Manol~t¢lur~d }lom~ or Modular <br />Dwelling Se~ic~ or Feeder $40,~ ~ 2 <br /> <br /> 200 amps or le~s ~ $50.00 ~2 <br /> 201 amps ~ ~0 am~ ~ $~.00 2 <br /> ~)1 amps lo ~0 amps $I~.00 ~ 2 <br /> <br /> Over i0~ amps <br /> Remnnect only $~,00 ~ 2 <br /> <br />C. T~p~a~y ~vi~e <br /> <br /> 200 aal~ or lcss <br /> 201 amps to ~0 am~ $~.(X) ~ 2 <br /> ~1 amps to ~0 am~ ~ $ffi,0O ...... 2 <br /> <br /> a) ~e fee foe btm~ch cimulm <br /> ~hase <br /> Each ~anch ci~uit <br /> <br /> b) ~e tee fo* broach clrcults ~lhotd <br /> ~0 of se~icc Q~r fcc <br /> Fire branch ~h~ait ~ $35.00 .. <br /> ~ ~8~itional branch eirouit <br /> <br />E. Mi~ellan~u~ (~rvi¢e ~ F~er N~ Include) <br /> ~eh pump or i~igation elrcl¢ $~.~ .... 2 <br /> ~eh sign or outline Iighl~ ~ ~.~ ~ 2 <br /> S~n~ circuit(s) or a lhnhed envy <br /> <br /> above, per ~peetJofl <br /> <br /> ~k og 10 labels <br /> <br /> (~ t~qui~d <br /> Aurora Dwelli~ El~ctrieat ~ ~, IL · $.06 = <br /> ~elli~ Pe~it ~bel <br /> <br />5_ FI~I~$ <br /> <br /> A2. Add 5% ~umharge (.05 x A I) <br /> <br />B, Enter 25% of line A 1 lbr Plan Review <br />(See, 3), if required $ <br />C, Investigation l:ec (ift~qui~fl) <br />D, R¢i~sper;tion Fcc(g25.00) $, <br /> TOT~ ~OU~ DUE $~ <br />Receipt No, <br /> <br /> <br />