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FOR CITY VALIDATION[ <br />Received by: <br />Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br />COMMUNITY DEVELOPMENT CENTER <br />285 Church St NE - Room 132 <br /> Salem, OR 97301 <br /> <br />24 Hr lns~tioa Line: 588-7904 <br />Ottlce: $88-5147 &00a.m.-4:30p.m. <br />FAX: 588-7948 <br /> <br />IELECTRICAL PERMIT APPLICATION <br /> Please complete all Sections, 1 through 5 <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />PF~ MITS ARE NON-TRANSFI~RABLE AND EXPIRE IF W IS N <br /> I <br /> STARTED WIT}lIN 180 DAYS OF ISSUANCE OI~IF~ ,~ [ <br /> WORK IS SUSPENDF~) FOR 180 DAYS, <br /> I <br /> ¢OmRACTO IN rALLATXON Dray qS- <br /> <br />Sup~wisor'a License No, [ Phone <br /> <br />2B. FOR OWN'~R INSTALLATIONS <br /> <br />rmf, eay Owner (plo,'tse pvi~O <br /> <br />3, PLAN REVIEW 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 />MC'/,5 34 12/!~ <br /> <br />PERMIT NO: <br /> <br />Date: ~'~//~ q'~e- <br /> <br />Issued by: <br /> <br />4. FEB SCHEDUL~ (Complem and ealtel' ~0[al i~ Al below) <br /> <br /> 1~ aq, fl, or less $85.(X) 4 <br /> <br /> ~mig~ ~nergy $20,~ 1 <br /> ~eh Ma0ufaetured Hom~ or Modular <br /> D~ or Feeder $40,~ 2 <br /> <br />B. S~vlee. ~F~ ~es not include b~neh cJ~uil~, see section D) <br /> Inatallatio~on or R~atlon <br /> 200 amps or le~ ..... ~ $~.00 2 <br /> ~1 amps to ~ amps $~.00 <br /> ~1 amps to ~0 amps $1~,00 2 <br /> ~1 raps to 1000 ~nps $130.00 <br /> Over 10~ amps ut vol~ $3~.00 <br /> Reeonn*ct only $~-00 <br /> <br />e. Temp~aty ~vi~ <br /> <br /> 200 am~ or leas $3&00 2 <br /> 201 amps to ~0 amps ~0.00 <br /> <br /> a) ~e Cee for bmn~h ¢h~uits ~ <br /> pumhase of g~ice ~eeder fe~ <br /> ~ bran~ eimuR [ $ <br /> <br /> b) ~e fee for branch circuits ~ <br /> <br /> (s~d only to ~leotrical oontractors) <br /> <br /> (~ requit'e~ by Buildi~ <br /> <br /> <br />