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IFOR CITY vALIDATION <br />Re~eiwd by: <br /> Date:. : ~ <br /> <br />MARION COUNTY BUILDING INSPI~CTiON <br />COMMUNITY DEVELOPMENT CENTER <br /> 285 Church St NE- Room 132 PERMIT ~ <br /> Sale. re, OR 97301 <br /> <br /> Date: , IVIARtDN COUNTY <br /> 24 I-Ir Inap~tio~t Linen 588-?904 <br /> Off-m,: 588-5147 8:00 a.m.- 4:30 p.m. BUiLDInGINSPECTION <br /> FAX: 588-7948 JSSUl;td by; <br /> <br />IELECTRICAL PERMIT APPLICATION <br /> Please oomplete al~ Sections, I through <br /> <br /> 1, LOCATION OF INSTALLATION <br /> <br /> Job A dd~-";~ <br /> cay J,L~ s~ <br /> <br />: pli~.Mrr s Al~ N ON -TILAN $FEI~ABLIL AND EXPllZE I~ w OP.K IS N aT <br /> : STARTED WITHIN 180 DAYS OF ISSUANC~ OR IF <br /> WOI~K 15 SIJSP~e. NDED FOR 1 ~0 DAYS. <br /> <br />CONTRACTOR INSTALLATION ONLY <br /> <br /> FOR OWNIiR INSTALLATIONS <br /> <br />propeay Owner (please prinO <br /> <br />Mailing Addre.~s T Phone <br /> <br />3. PLAN'REVIEW SECTION <br /> <br /> Marion County does not require a plan review. <br /> We will provide plan review service if you complet~ <br /> Section 5B and submit two (2) sets of plans and <br /> specifications with this application. <br /> <br />MC l,f-.?4 1~2/04 <br /> <br />4. ~ SCH]E~Du1-.~]~ (Complete and enter total in Al below) <br /> Number oflnspectlon$ per I~rmit allowed ~ <br />.A. <br /> Ib:aldential <br /> Unit <br />8eerier Included: Items Cost (each) Sum I <br />IOO0 aq, ft. or le$s $~$.00 =.~4 <br />~ach additional SOO sq. n, <br /> <br /> Dwelling Servi~c or Feeder ~40.CX) --.~ 2 <br /> <br />201 ames to 400 ames $60.00 <br />401 aml~ to 600 am~ ~ $[~.~ 2 <br />~1 ~to l~p~ <br /> <br /> 2~ amps or le~ $3~,~ ,., <br /> ~1 am~ to ~ am~ ~.00 2 <br /> <br /> ~ braa~ oi~uit $ <br /> b) ~ f¢~ for b~anch ~i~uils ~t <br /> <br />$40,00 -- 2 <br /> <br />$40.00., 2 <br /> <br />$35,00 <br /> <br />$50.00 ~ <br /> <br />Ml~ellancous (Secvico ~t Fe~der Not Include) <br /> <br />~ch si~ or oulliae IJght~ <br />Signal oimui~s) or a limi~d encr~ <br /> <br />O~r the allowab{~ in any of~ <br /> <br />Mi~ Installati~ Lab~ <br />~¢k of 10 labels ~ $5,~ each <br />(~d only to electrical <br /> <br />Au~ra Dwelling El¢~trleal <br />Dwelling Pe~it ~boI /1 of ~bels <br /> <br />5. FEP~a <br /> Al. Enter total offe~ from $¢¢. #4 <br /> A2. Add 5% aurchatg* (.05 x Al) <br /> ~btotal <br /> <br /> B, ~nter 25% of linc A I tbr Plan R~vicw <br /> (Sec. 3), if ~qui~d <br /> C. Investigation Fee Of ~quJ~d) <br /> D. ReimP~elion Fee ($25,~) <br /> <br /> ~T~ ~O~ DUE <br /> Reez~pl No. <br /> <br /> <br />