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FOR OFFICE USE ONLY <br />Received by: <br />Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> 220 High Street NE <br /> Salem, Oregon 97301 <br /> <br /> Ptxm~ 588-5147 $:00 ara - 4:36pm <br /> Code-A-Fhone: 585-7904 <br /> FAX: 588-~94S SITE #: <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete all Sections, I through 5 <br /> <br />IpEJqAx4fI'S ARE NON-TRANSFERABLE A_ND NON-REFLrNDABLE AND <br /> EXPIRE IF WORK IS NOT STARTED wI-rHI~ 180 DAYS OF ISSUANCE <br /> OR iF WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />211, FOR OWNER INSTALLATIONS <br />pmpcr~y Owner <br />MaiJing Address Phon~ <br />C, ity/Sta~fZip <br /> <br />The [mtdtat[on i~ beL~g made oft prope~ [ o~vtl wbick is rt~- ~to. rtded for <br />lea~e, or rent. <br /> <br />-3. PLAN REVIEW SECTION <br /> <br /> We will provide plan review Service if you complete Section <br /> 58 and submit two (2) sets of plans and specifications with <br /> this appilcadon. <br /> <br />This optional plan review program docs not suspend the <br />required sabmissioa of lighting power calculations, plans, <br />':,nO specifications when required by the Oregon Sl~uctaral <br /> <br />Date: <br /> <br />Perrmt No. <br /> <br /> Issued by: <br /> <br />4, PgE SCHEDULE (Complete and cnNw lotal in ,\ l be!low) <br /> <br />A, Residential Per Unit <br /> Service Included: <br /> <br />10410 sq, ft. or less $85,00 <br />Each additional 500 sq, ft. <br />or pond. on thereof $15.00 <br />L~nitcd Energy ~, $20,00 <br />~<h Manufd HOmo or M~ular <br />D~c~ Se~ or Feeder $40,00 <br /> <br /> ~ am~ or les, ~ ~60.00 <br /> ~l ~mps m 1~0 am~ ~ ~30,~ <br /> ~ 1000 ~p~ or volt~ ~300.00 <br /> Re~nnect ~ly ~ $40.00 <br /> <br />Temporary Service$/F~eder$ <br /> <br /> E~ch sign or out,ne <br /> <br /> Pack of 10 la~s <br /> <br /> (As required <br /> <br /> VaES <br /> <br />A2. Add 5% ~urcha~e (.05 x A I) <br /> <br /> ($<. 3), if ~q~r~ <br />C, [nvestigatlonFee (ffmqu/red) <br />D, Rcinslmcfi~ Fee ($25.00) <br /> <br />$35.00 <br />$40.00 <br />$80.00 <br /> <br />$35,00 ~ <br /> $2.00 <br /> <br />$40.00 <br />$40.00 <br /> <br />$40,00 ~ 2 <br /> <br />$35.00 <br /> <br />$80,00 <br /> <br /> <br />