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.. . MARION' COUNTY BUILDING <br />FOR cfi~ i : ,DATIONi 285 Church St NE- Room 13Z <br /> <br /> F~: 588-79~ <br /> <br />ELECTRICAL PERMIT APPLICATION <br />P/ease complete all ~eetions, I tl~rough <br /> <br />il LOCATION OF INSTALLATION <br /> <br /> ~R~S A~ NON-~NS~B~ AND ~I~ ~ W0~ IS N~ <br /> STAR~ ~ 1 ~ DAYS O~ iSSUANCB 0R ~ <br /> WO~ I~ ~U~P~D~ ~OR Ii0 DAY& <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br /> Contractor ] Phone <br /> <br />Mailing Address <br /> <br />.lob No. <br /> <br />3, PLAN RI~VIEtW SIiCTION <br /> <br />Marion County does not .require a plan review. <br />We will provide plan review service if you complete <br />Section SB and submit two (2) sets of plans and <br />specifications with this application. <br /> <br />4, FI~I~ SCHEDULE (Complete and enter total in Al below) <br /> <br />A. R~ideoti~l PR Unit Number of Inspe~tion~ pet permit aliowe:d ~ <br /> <br />Servlco Included: barns Cost (each) <br />1000 sq, ft, or less $g5.00 <br />Each additional 3tX) sq. t~. <br /> or potties thereof $15,00 <br />Limited Energy $20,00 <br /> <br /> Dwelling Service or Feeder $40.00 <br /> <br />200 amps et <br />201 amps to 400 amps $60 <br />401 amps to 600 amps $10()10lt <br />601 amps to 1000 amps $150.00 <br />Over 1000 amps or volI~ $300,00 <br />Reconnect only $40,00 <br /> <br />200 claps or less <br /> <br />~g) l amps tO 600 <br />Over 600 amps or 1000 volt~ <br /> <br />a) The fee for braaoh oireuits with <br /> <br />First branch circuit $35,00 <br />Each addltloaal braneh circuit $ 2.00 <br /> <br />El Misedlancous (,'~'vi~ o~ F,~ N~ Indudod) <br /> ~& pump or i~igation <br /> ~ch si~ or outline li~tiog <br /> Signal circuit(s) or a limited enorgy <br /> <br />P, Rach additional Insp~lion <br /> Over th~ allowable in any <br /> above, ~r l~pection <br />O, Mia~ InstaEation Lab,s <br /> Pack of 10 labels ~ <br /> <br />H. 0~ <br /> <br /> ~dling P~mfit <br /> <br />$40,00 ___ 2 <br />$40,00 2 <br /> <br />$~'~ .... 2 <br /> <br />$35,00 <br /> <br />$5O,00 <br /> <br />FEES <br />A I1 ~'rlt¢{' total of fees from Seal #4 <br />A2. Add 5% surcharge (,05 x Al) <br /> Subtotal <br /> <br />B, Enter 25% of lioe Al for Plan Review <br /> ($e¢. 3), if ~qui~d <br />C, Investigation Pe~ (if required) <br />D, ~imp~tMn Fcc ($25,~) <br /> <br /> ~T~ ~O~ DUE <br /> Receipt No. <br /> <br /> <br />