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Received by: * e,~! 220 High Slxeet NE <br />Date: ~ ~'~ I~¥ ~ ¥F Salem, Oregon 97301 <br /> Phone 58S-5~47 S:00 :am - 4:3{¥m <br /> Code-A-Phon~: 588-7904 <br /> PAX: 588-Tg4S <br /> <br /> Please complete all Sections, I through <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br /> LOCATION OF INSTALLATION <br /> <br />E~E ~ WO~ I$ NOT STATED ~ 180 DAYS OF <br /> <br />2A. COllAtOR INSTALLATION ONLY <br /> <br /> " <br /> <br />lB, FOR OWNER INffPALLATIONS ! <br /> <br />We will provide plan review service if you complete Section <br />5B and submit two (2) sets of plans and specifications dth <br />this application. <br /> <br />This optional plan review program does not suspend the <br />required submission of lighting power calculations, plans, <br />and specifications when required by the Oregon Structural <br />Specialty Code, Chapter 53. <br /> <br />MC 15d4 11/91 <br /> <br /> ~ ~, ,.;o ~ % \,91 <br /> <br />1~ aq, ~ ~ less $B5.00 ....... <br /> <br />oc~ thamof $15.00 <br />L~md ~nc~y ~ $20.00 <br />Ea~ Manufd I.[omc or M~ <br />Dwe~g Se~< or Feeder $4030 ~ 2 <br /> <br />B- $er~'~ or FeVers ~s noI ~de ~ch d~[~, s~ sccfi~ <br /> <br /> Installation, Altceations or Relocation i <br /> 200 amps or I~ss ~ $60.00 <br /> 201 traps to 400 amp~ $60.00 <br /> 401 am~ to 600 ~u'~pS ~ $100,00 <br /> 601 amps to 1000 amps $130.00 <br /> Over 1000 ~mps or volu $300.00 <br /> Keomr0act ouly $40,00 <br /> <br />C. Temporary Servtces/F~ders <br /> <br /> 200 amp~ orl~ $$$.00 <br /> 201 am~ ~o 400 amp~ $4030 <br /> <br /> a) Tlae f~ for bnnch ~muim ~ <br /> <br /> ,~mha~ of*e~e~ or fcd~ f~e <br /> <br />L Mlallan~Ui (~¢[vlee or Fee~r Not Included) <br /> Signal ~mit(~) ~ a h~tad enemy <br /> <br />E ~ch additional hsp~tion <br /> ~er ~e ~ab~ ~ any of ~e <br /> <br />G. Minor Insmllatlon La~is <br /> <br /> (soM only to electrical comractors) <br /> <br /> ( A*' ~q~red by Build~ Off~O <br /> <br />$S5,00 <br /> <br />$40.00 2 <br />$40.00 -. 2 <br /> <br />$4~.00 2 <br /> <br />$35,00 <br /> <br />5. FEES <br /> Al. Enter total of fees from Sec. #4 <br /> A2, Add 5% surcharge (,05 x Al) <br /> <br /> Subtotal <br /> B. Efll~r 25% of linc A1 for Plan Review <br /> <br /> C. Invedgation l;e~ (if required) <br /> D. Reinspedm Fee <br /> <br /> TOTAl, AMOU1Wr DUE <br /> <br />$ ,5},, <br /> <br />RecclF No, ,, , <br /> <br /> <br />