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FOR CITY VALIDATION <br />Received by: <br />Date: <br /> <br />ELECTRICAL PERMIT APPLICATION <br />P/ease complete all Sections, I through 5 <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVEL?PMENT CENTER <br /> 285 Church StNE- Room 132 <br /> <br /> 24 Itt Insp~tion Lmo: 558-7904 <br /> Off, e: ~88-5147 8:~a.m.-4:30p.m...~ ~... <br /> <br /> ~Hll <br /> <br />PERMITS ARE NON-2~.ANS FERABLE AND EXPIRI~ IF WORK IS NOT <br />STARTED WITHIN 180 DAYS OF ISSUANCI~ OR IF <br /> WORK lg SUSPENDED FOR 180 DAYS. <br /> <br />PASrKIN EELECTRIC:, INC. <br />20?.50 S. MOLALLA AVE. <br />OIRIEGON C I'FY, OR 97045 <br />657-4958 <br /> <br />F ONTRA~ ']- n. , <br />-: .-, OR,~) LICENSE :~ 34-4C <br />CON'TRACTORS [~OAF:,D REda. ~ 35151 <br />C~tJPI~RVI SOR ¢~ 1313-S <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br />~M_a?_n_{~ Add~s ....... [Phone <br /> <br />City/State/Zip <br /> <br />3. PLAIN REVIEW SECTION <br /> <br />IMarion 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 />4_ FEE SCHEDULE (Coff~plele and enter lotal in Al below) <br /> <br />1000 $q, lt. or le~a $85.00 4 <br /> <br /> Dwelling Service or Peeder $40,00 __ 2 <br /> <br /> 200 amps or less $50,00 __ 2 <br /> 20 ! amps to 400 amps $60,00 __ 2 <br /> <br /> 601 amps lo 1000 maps $130,00 ---- 2 <br /> Over i000 amps or volta <br /> <br /> 200 amps or less SJS,00 ..... 2 <br /> <br /> a) The fee for branch eh*uils <br /> <br /> Each branch circuit <br /> <br />b) The fee for brauch drouits milk,.ml. <br /> <br />First branch circuit <br /> I <br />Each additional bnumh clrcult <br /> <br /> Each pmnp or irrigation circle <br /> Each sign or outline li~hting <br /> Signal eii~uit(s) or u lhnit~d energy <br /> <br /> Pack o£ I0 labels @ $$,00 ~aeh <br /> <br />H. Other <br /> (A~ reql~ired by Budding OEi*iaD <br /> <br />Miscellaneous (~rvleo or F~'dee N(X Inoluded) <br /> <br />$ 2,00 <br /> <br />$40.00 2 <br />$40.00 2 <br /> <br />$40,00 2 <br /> <br />$35,00 -- <br />$50,00 <br /> <br />__.,% g. x $.06 =__ <br /># of Labels _Nlq <br /> <br />5. [°EES <br /> A I, Enter total of [~e$ ft'3m Sec, #4 <br /> Ag. Add $~ stlrcharge (.03 x Al) <br /> <br /> B. Enter 25% of linc A l for Plan Review <br /> <br /> ~. Inve~figatlon Fee (i~mqui~d) <br /> D. Relmpectlon Fe~ <br /> <br /> TOT~ ~OU~ DUE <br /> Receipt No, <br /> <br /> <br />