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FOR CITY YALIDATION <br />R~eived by:,, <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 lnsp~tion Li~o: 588-790~ <br />Office: 585-5147 8:00 a.m. - 4:30 <br /> F~: 581~-7948 <br /> <br />ELECTRICAL PERMIT APPLICATION' <br />Please complete all Sections, I through 5 <br /> <br /> , LOCATION OF INSTALLATION _ <br /> <br /> P~TS A~ NON-~N$~B~ AND ~PI~ ~ ~O~ IS NOT I : <br /> STAR~ ~ 1~ DAYS OF ISSUAN~ OR IF ~ <br /> WOOls SU~P~D~ FOR 180 DAY& ,, <br /> <br />~. CO~CTOR ~LATION O~Y '' <br /> <br /> " x ' -' <br /> <br /> ...... . , <br /> <br />~, *OR OW~ ~LATION <br /> ~ST S :' <br /> <br />M~ailing Addrms ] Phone <br /> <br />3. PLANRI~VIgW SECTION <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 /> specifications with this application. <br /> <br />MC' I,*;-.14 IZ4'4 <br /> <br />Issued by: ~.aARION COUNTY <br /> BUILDING INSPECTION <br /> <br /> 4. F~ 8CHF:~)UI~ (Compl:tc and entel' lotai in A l below) <br /> <br /> 10~ sq, ~, or less <br /> Limited Energy ~ $20.~ ~ 1 <br /> <br /> ~clling Se~icc Or Feed~ ~0,~ ~ 2 <br /> <br />B~ ~V~ or F~m (~ ~ ~ludc br~h dmui~ se~ section D) <br /> 200 ampa or le~ <br /> <br /> ~ l amps m ~0 amps .,, $1~,00 .., 2 <br /> <br /> ~er 10~ amps or ~1~ <br /> Rcmnne,t only ~ $~,~ .... 2 <br /> <br /> ln~tl{k~ion, ~twli{on, ~ Relmtlon <br /> <br /> ~1 amd to ~0 am~ $~.00 2 <br /> ~1 m~ to ~ amps $~.~ 2 <br /> ~er ~0 ~ps or 1~ volta <br /> <br />D, Btan~ Cltouas <br /> <br /> ~) ~c fce f~ b~ch ~ui~ <br /> p~ of ~icc of ~der f~ <br /> ~ch brun~ cJ~uit $ <br /> <br /> b) ~e re* for branch cimuits <br /> <br /> P~ b~h clmuit $35,00 <br /> ~k ad~t~nal b~ch civet $ 2,00 <br /> <br /> ~h pump or i~ation ~imle $~.00 <br /> <br /> $~n~ clw~t(s) or a limned envy <br /> <br />~. ~ additional Insp~ion <br /> <br /> u~ve, p~r InapeCtion <br />O, M~ Instalhtion Labe~ <br /> P~k of I0 lab~la ~ $3,00 m~h <br /> <br /> (~ ~quiccd by Buildi~ O~iaO <br /> <br /> ~clliag Pc~uit ~bcl <br /> <br />FEES <br /> A I, Enter k~tal of f~e~ from Scc, <br /> A2, Add 5% autchu~e (,05 x Al) <br /> <br />B, ~ter 25% of lineAl for P~n Review <br />(Sec, 3), if ~qui~ $.~ <br />C, lnw~t~ation F~a 0f~q~d) $.~ <br />D, Reimpoetion F~e ($25.~) $_ <br /> <br /> <br />