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I <br />FOR CITY VALIDATION <br />Received by:. <br />Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMI~NT CENTER <br /> 285 Church St NI~ ' Room 132 p <br /> <br />24 Hr Inspection Line: 588-"/904 <br />Office: 588-5147 ;g:00a.m.-4:30p.m. <br />FAX: 588-7948 <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Plet~so completo all Sections, 1 throggh <br /> <br />pERMiTS AI~E NON.TRANSFERABLE AND EXPIRI~ IF WOl~¢, 1S NOT " <br /> STARTED WITHIN lg0 DAYS OF I$$1.,rANCIE OR IF <br /> <br />'2A C~ONTRACTOR IN$'TALLATION ONLY <br /> <br /> PARKIN ELEC:Tf~.IC:, INC:. <br /> 20250 o <br /> ~. MOt. AL. LA AVE. <br /> ORE(~ON CITY, OR 97045 <br /> <br /> bONII.,AUTOkS LICENSE *~ 34-4C <br /> ..,ON]RAL-¢OI,S BOARD REG, ~ 35151 <br /> <br />Supe~i~or's Lic¢n*O No, Ph~c I <br />~. ~OR OW~R ~ST~LATION8 <br /> <br />Mailing Addreas ] Phone <br />C'/ty/Stata/Zip <br /> <br />3. PLAN'RHVIBW SBCTION <br /> <br /> Issued by~ ................ <br /> m,~mup~ uuup~l f <br /> <br /> .... ~I, IILOINP: INSPFCTION <br /> <br />4. ~E SCHemE (Complete and ent~ ~m] in Al b~low) <br /> p~ <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 />specitkations with this application. <br /> <br /> 200 amps or lea $50,00 -- 2 <br /> 201 amp~ Io 400 amps $60.00 -- 2 <br /> 40 [ ampa to lIll0 amp~ $100.00 2 <br /> 601 aml~ to 1000 amps $130,00 .... 2 <br /> <br /> 290 amps or te~ $35.00 -- 2 <br /> <br /> a) The fee for branch cimult8 ~ <br /> Each branch eimult $ 2,~) .... <br /> <br /> Fimt branch e;ix~uit / $35.00~~l) <br /> <br /> pa~ei, Mt~raii0n o~ ~it~nsi0n $40.00 -- 2 <br /> <br />G. Mia~r Installation Labeb <br /> Peek or' ~0 labels @ $5,00 each $30,00 <br /> <br /> (A~ r~quirod by Building Olfioial) <br /> <br />Dwelling Pormit Label # or' Labeb .... <br /> <br />5. FEES Al. Enter total of£ees from $~, #4 <br /> A2, Add 5% surcharge (,05 x Al) <br /> <br /> B. ~n~r 23% of ]in~ Al ~or Plan ~evlcw <br /> (Sec. 3), if ~qui~d <br /> <br /> D. ~ci~pection F~ <br /> <br /> TOT~ ~OU~ DUE <br /> <br /> <br />