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FOR CITY VALIDATION <br />R~e{vcd by'-~ <br />Date: <br /> <br />ELECTRICAL PERMIT APPLICATION <br />P/ease cam_plate all Sections, I through <br /> <br /> AmON COtWrr¥ sUn. r S .CT ON <br /> 285 ~urch st NE Room 132 <br /> Salem, OR 97301 <br /> <br /> O~: ~88-~t47 8:~ ~,m.~ 4:30 F~; 58g~7948 <br /> <br />1. LOCATION OF INETALLATION . <br /> <br /> PERMITS ARE NON-TR~-NSP'~RABLE AND EXpIKE IF WO~ I~ N~ , <br /> STARED ~THIN 1 ~ DAYS OF ISSUAN~ OR IF <br /> WO~ I$ SUSP~DED FOR 180 DAYS. <br /> <br />~. CO~RACTOR ~LATION O~Y <br /> <br /> 2B. FOR OWNER INSTALLATIONS <br /> <br />.~M_a. ilirlg AiIdr¢.% ___..~ Phone <br /> <br />3, PLAN RB¥IEW SECTION <br /> <br /> Marion County does not require a plan review, <br /> We will provide plan review setwice if you complete <br /> Sectkm 5B and submit two (2) sets of plans and <br /> specitications with this application. <br />MC I,~.14 !~4 " ' <br /> <br />4. FI~B SCHBDULE (Complo/¢ and enter total in Al b~low) <br /> Number of lnap~e~na pet ~it alDwcd ~ <br />A. <br /> RmidentJal <br /> Unit <br /> ., <br /> <br />1~ ~q, fl, ~ I~s ~ $B5.~ 4 <br />~ch ,ddifioaal 5~ sq. fl, <br /> <br /> Limited Etl~l'gy ~ $20.~ 1 <br /> Dwelling Se~i~ or Fe~r $40,~ .2 <br /> <br /> 401 amps to 600 <br /> 60l at~ to 10OO <br /> <br /> C. Tomp~ary ~J~er~ <br /> <br /> 200 ~ or leas <br /> <br /> ~1 mn~ to ~0 amps <br /> O~r 60O ~a or 10~ volta <br /> <br /> D. ~tan~ <br /> <br /> a)~e f~o for brach c~ui~ ~ <br /> pumhase of se~ie~ <br /> <br /> b) ~e leo for brunch oirouit s ~ <br /> <br /> Fim~ b~neh cimoit <br /> <br /> ~. Miscel~n~us (~v/ce ~ F~ N~ Include) <br /> ~ pump or i~ati~n oimlo ~,, <br /> <br /> Signal ~i~uit0) or a Iimlteg ~n~ <br /> <br /> a~ve. p~ Impect{on <br /> <br /> ~k of 10 labels ~ $~.00 <br /> (s~d only w electrical co~rzotot~) <br /> <br /> (~ rcq~flvd by Boildi~ <br /> Dwclliog Pcmlil ~bel ~ of ~bol*~ <br />' 5, <br /> A~, Ada 5% $~mharge (,~5 x A I) <br /> <br /> B.Ent~r 25% of tine A 1 for Pis~ <br /> (Sec, 3), if t~quj~d <br /> C, lnvcst~al{ofl F~e <br /> ~, Reii~pcclion F~ <br /> <br /> TOT~ ~OU~F DU~ <br /> <br /> $50.0O ~2 <br /> Sd0.00 ....... 2 <br /> $100.00 2 <br /> $130_0O _,, 2 <br />-,, S30O.0O --- 2 <br /> $40.00 ,,, 2 <br /> <br />- $35,00 2 <br />., $40,00 ___2 <br /> $80.0O. 2 <br /> <br />$40.00 -- 2 <br /> <br />$35,00 --,, <br />$50,00 ,, <br /> <br />$40.0O _ 2 <br />$40,0O .., 2 <br /> <br />$35,0O ---- <br /> <br /> <br />