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NOR CiTYVALIDATION <br />R~eivadby:. <br />Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br />COMMUNITY DEVI~LOPMENT CENTER <br />285 Church St NE · Room 132 <br /> Salem, OR 97301 <br /> <br />ELECTRICAL 'PERMIT APPLICATION <br />~lease complete all Sections, I through 5 <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />24 Hr Inspection Lin< 588-7904 <br />Office: $88-5147 8:00 a.m. - 4:30 p,m. <br />FAX: $88-?948 <br /> <br />Elea~iej~ <br /> <br />2B. FOR OWlffflR INSTALLATIONS <br /> <br />Mailing <br /> <br />Marion County does not requipe a plan review. <br />We will provide plan review service if you complete <br />Section 5B and submit two (12) sets of plans and <br />specifications with this application. <br /> <br /><?5 '-,/o 2 /2_ <br /> <br />D~o: <br /> <br />Issued by: <br /> <br />4. FiEE $CHIgDIJL~ (Complete and *nter total in Al below) <br /> <br />A, <br /> R~dential <br /> P~ <br /> Unit <br /> ~vi~ lneind~: Ite~ ~at (each) Sum <br /> 1~ sq. ~, or lean $83,~ 4 <br /> <br /> or ~ion ~e~of $15.~ <br /> <br />200 ampa or less $~0,00 2 <br /> amps to 400 amps T $~'~ <br />~I am~ to 10~ amps $130,~ ., ~ <br /> <br />2~ amps or le~ $35.00 ~ 2 <br />201 ~ to ~ amps $~,~ 2 <br /> <br />a) %~ fee f~ b~h ei~ui~ ~ <br /> <br />F~t br~h c~uit $35.00 .... <br />~ch additional brach ~ult $ ~.~ <br /> <br /> ~aeh pump or iffigation circle <br /> Each sign or outline lighting <br /> Signal circuit(s) or a limited energy <br /> <br />P. ga~ additional l~p~tlon <br /> Over the allowable in any of <br /> <br />G, Min~ Installation <br /> Pack of lO labels ~ $3,~ <br /> (sold only to electrical ~o~tractors) <br /> <br /> (~ required by Buildi~e O~claO <br /> A~mra ~lling Bl¢otfionl <br /> <br />Miscellaneous (Se~rviee ~r Feeder No{ Included) <br /> <br />$40,00 .... 2 <br />$40,00 2 <br /> <br />$40.00 2 <br /> <br />$35,00 ..... <br /> <br />$50.00 _., <br /> <br />__.sq. g. x&06 = __ <br />ff of Labels <br /> <br />5. PER8 <br /> Al. s~i~r total of fees £rom St~, #4 <br /> A2. Add 5% surcharge 605 x Al) <br /> Subtotal <br /> <br /> g. ~tot 25% of llne A 1 for Plan Review <br /> (Se~, 3), if ~q~d <br /> ~. Inve6tigulbn Fee (if raqui~d) <br /> D. ~i~paetbn Fe~ ($25,~) <br /> <br /> TOW~ ~O~ DUE <br /> Receipt No, <br /> <br /> <br />