Laserfiche WebLink
FOR CITY VALIDATION <br />Received by; <br />Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br />COMMUNITY DEVELOPMENT CENTER <br />285 Church St NE · Room 132 <br /> Salem, OR 97301 <br /> <br />24 Hr ltl~poetion Line: 588-7904 <br />Office: ,588-5147 8:00 a.m. - 4:30 p.m. <br />FAX: 588-7945 <br /> <br />ELECTRICAL PERMIT APPLICATION <br />P/ease complete all Sections, i through <br /> <br />1. LOCATION OF INSTALLATION <br /> <br /> y x. +., , <br /> <br /> STARED WI~IN i~ DAyS O~ iSSUANCE OR IF <br /> WO~ 15 SUSP~DED FOR 180 ~AYS, <br /> <br />2A, CoITrRACTOR INSTALLATION ONLY <br />El¢¢tricalComra~Jtor Judaon's, Ina. j Phon¢ <br /> <br />cL <br /> <br />MailingAddr~ss PO BOX q2669 Salem, OR 97309 <br /> <br />215. FOR OWIX~R INSTALLATIONS <br /> <br />P00p~ny Owller (please pci~O <br /> <br />City/SmtedZip <br /> <br /> 3. PLAN' RBVIBW 8BCTION <br /> <br /> M~rion County does not require a plan review, <br />We will provide plan review service if you complete <br />Section 58 and submit two (2) sets o£plans and <br />l spe¢ifieati, ons with this application. <br /> <br />MC Ly-34 I~.~ <br /> <br />PERMIT NO: <br /> <br />Date: <br /> <br />Issued Dy: <br /> <br />4. i~1~ $CHF~DUL~ (Complel¢ and enter tolnl in AI be~w) <br /> <br /> R~idontial <br /> Unit <br /> <br />10~ ~q. a. or l~ss $85.~ 4 <br />Limited ~rgy <br /> <br /> 200 amps or <br /> <br /> 401 mn~ to 600 amps <br /> <br /> 12Bl~Jlase o F~yvlcc ot'~eder <br /> <br /> purchase, gl se~ie~¢~ <br /> <br />E. Mi~ellan~us (~rvice~ P~er N~ Include) <br /> <br /> Signal zi~ui~(s) or a limited <br /> <br /> Over th~ allowable hi any <br /> <br /> Pack of 10 Iabeh ~ $5.~ each <br /> <br />H. Oth~ <br /> (A~ required by Building O~ciaO <br /> <br /> $50.00 -- 2 <br />$60.00 2 <br />$100.00 2 <br />$130,00 2 <br />$300,00 2 <br />$40,00 2 <br /> <br />$35,00 2 <br />$40,00 2 <br />$80,00 .,, 2 <br /> <br />$ 2,rE, <br /> <br />$40,00 2 <br />$40.00 --- 2 <br /> <br />$40,00 -- 2 <br /> <br />.... $35,00 __ <br /> <br />$50.00 _ <br /> <br />__ ~q. lL x $.06 =__ <br />ff of L~be ~, <br /> <br />5. FEES <br /> A 1. ]Eh~t er lolal of fees £to,n Sec.//4 <br /> A2, Add 5% ~utchargc 605 x A 1) <br /> <br /> B. Enter 23~ of]in~ Al tbr Plan Review <br /> {Sea. 3). if r*qgimd <br /> C. Inwatigaiion F~* (if~quimd) <br /> D, Rei~pection Fee ($25,~) <br /> <br /> TOT~ ~OU~ DUE <br /> <br /> /,%,2- <br /> <br />$ <br />$ <br /> <br /> <br />