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Ep/easLECTRiCAL I~ERMIT APPLICATION <br /> o comploto all Sections, I th. rough 5 <br /> <br />MARION COUNTY BIJILDINO INSPECTION <br />COMMUNITY DEVELOPMENT cENTER <br /> 285 Chumh St NE * Room 132 PERMIT NO: <br /> Salem, OR 97301. <br /> <br /> Date: <br /> 24 Hr la~o~tion Liam 588-7904 <br /> Office: 588-§147 8:00a_rn.-4:30p.m- <br /> · ~ /~ls.~z~ed by:., <br /> <br />1. LOCATION OF lJNSTALLATION <br /> <br /> pERM1T~ ARJ~ NOH-TRAN$~'~IL~BI~I AND E~ ~ WO~ IS N~ : <br /> S'FA~D ~ l~ DAYS OF [SSU~ OR 1F <br /> WO~ IS SU~P~D~ FOR 180 DAYS. <br /> <br />~. CO~ACTOR ~LATION O~Y <br /> <br />2tl. I~OR OWNER I]~ISTALLATION~ <br />P~perly Ovmer (ple~ <br /> <br />Mailing Address [ phone <br /> <br />3. PL,A~RtlVIItW 81~CTION <br /> <br /> Marion County does not require a pla~ reviewl <br /> We will provide plan review service if you complete <br /> Seetiou 50 and submit two (2) sets of plans and <br /> specifications with this application. <br />~c5.~.:~4 ~4 .... <br /> <br /> 200 amps Or leas _ <br /> 201 amps 10400 am~$ <br /> 401 amps lo d00 amps - <br /> 601 amps Io 10O0 amps <br /> Over 100O ~mps or volta <br /> <br /> 200 amga ~r 1¢~ .... <br /> <br /> Over 600 amps or I000 volt3 <br /> <br /> a) The fee for branch eimult~ <br /> ~,~' ser,~i¢ e et' f~k, lXt~_ <br /> Each b~aaeh uireuh <br /> <br /> b) Tha fee for branch ¢imuRs without <br /> <br /> ~4~eh additional branch clo:mt <br /> <br />E. Mi~llaneoaa (Service ~ F~ N~ l~elnd~) <br /> <br /> $i~al eimult(s) or a llmiled eaerb~ <br /> <br />F. Each additional Inap~tlon <br /> <br /> Pack of 10 hbels ~ $~.~ <br /> <br />H, Oth~ <br /> (~ r~vired by ~ildi~e <br /> Auwm ~el]ing ~]~e~al <br /> Dwelling ~it ~bel <br /> <br />5, FgES <br /> <br />Al. Entel totalofl~ea frmn S~¢. #4 <br />A~. Add 5% ~urehatge (.05 x At) <br /> <br />B, ~t~r~ ofliaeAl for g~a ~view <br /> (se0, 3), if mqui~d <br />C. Inwat~ation Foe (if ~quirefl) <br />D, Rei~pcction Fee ($25.~) <br /> <br /> TOT~ ~O~ DUE <br /> <br /> $50.00 ,,, 2 <br /> <br />SW0.0O <br />$130:0O 2 <br />$300.0O " <br /> $40.00 <br /> <br />$35.00 . - 2 <br />glO.00 . - 2 <br />$80.0O - 2 <br /> <br />$ 2.00 <br /> <br />$40.00 _ 2. <br />$40.00 - 2 <br /> <br />$35,0O ~, <br /> <br />$50.OO , <br /> <br />4. }*HI/$CHI/DUL~ (Complete and ente¢ lotal in Al below) <br /> Ntunbet of Ino~otio~ <br /> ~it <br /> <br /> ~vi~ Include: l/e~ Co~t (oath) <br /> $85.~ <br /> <br /> or ~on ~e~f $ l 5,~ <br /> <br /> <br />