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FOR CITY VALIDATIONI Received by: ' I Date: [ MARION COUNTY BUILDING INSPECTION COMMUNITY DEVELOPMENT CENTER 285 Church St NE · Room 132 I:~FIM~T NO: Salem, OR 97301 Date: 24 Hr ln~pection Line: 588-7904 Office: 555-5147 8:00a.m.- 4:3Op,m. FAX: $8g-~48 Issued by: ELECTRICAL PERMIT APPLICATION P/ease complete all Sections, I throttgl~ 1- LOCATION' OF INSTALLATION STARTED WITItlN 180 DAYS OF ISSUANCE OR IF WORK IS SUSPENDED FOR 180 DAYS, CONTRACTOR INSTALLATION ONLY Mailing Address ......................................... l' Phone Signature of Sup~'ialng .~xi~k~ :5. PLAN RBVII~W SECTION ISecthm 5B and submit two (2) sets of plans and specifications with this application, Marion County does not require a plan review. We will provide plan review service if you complete 1.5-34 12/q4 NumbEr of Insp=~liona ~nu/I allowed 1~ Sq, B, or lo*~ $83,~ 4 Or ~ion ~er¢of $ I 5.~ Dwolling Se~i~c or Feeder ~ $40,~) ~_ 2 · -~I ampa to ~ amps Over 1000 ampa or' volts _ S) The fee for branch ¢ rcuitq ~'-~ch branch ¢ircttil b) The t~0 for branch circuits Fim~ bcanch clr~it Each additional branch ~ke~t ~ ~{~ of ouflhle li~tlng Signal ¢~uit(o) or a Ih~ilCd on~gy ~ek of 10 labels ~ $5,~ each OoM only to el~triczl contmctorO H. ~h~ (~ t'eqnired by Boildi~ Aum~ ~elli~ El~tfi¢al Fee ~elling Pa~it $50,00 _~__2 $60.00 $130,00 ,~2 · $300~0 2 $40.00 $35,00 ,. 2 $40.0o ........ 2 $1~).00 -.-- 2 $35.00 $40.00 2 $40,00 2 $40.00 ,, 2 $35,00 $50.00 .sq. IL x $,06 = # ot'Label* ....... ~/_~.] - FEES Al, Entel' total of I~ea from Sec. fi4 A2, Add 5% sumhargo (,05 x AL)