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FOR CITY VALIDATION <br />Received by: <br />Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br />COMMUNITY DEVELOPMENT CENTER <br /> <br />285 Church St NE · Room 132 <br />Salem, OR 97301 <br /> <br /> 24 Hr Insp~tion Lin~; 588-7904 <br />Oflloo: 58g-5147 S:00 a.m. - 4:30 p.m. <br /> <br />ELECTRICAL PERMIT APPLICATION <br />?lease complete all Sections, 1 through 5 <br /> <br />t. LOCATION OF INSTALLATION <br /> <br /> :. /, ...... <br /> ~,~,~,, ,,, :. ~. <br /> issued ~y. ~' <br /> <br />8C~ (Complete and exlt~ lol~l iff A,[. below) <br /> Unit <br /> <br />PERMITS ARE NON-TRANSFERABLE AND EXPIRE iF WORK IS NO'I' <br />STARTED WITHIN 180 DA YS OF ISSUANCE OR IF <br /> WORK ts SUSPENDED FOR 18~ DAYS. <br /> <br /> comRAcToR mST,W.A 'IO <br /> <br />2B, FOR OWNI~R INSTALLATIONS <br /> <br /> 3, PLANRRVIgW SECTION <br /> <br />IMarion County does not require a plan review. <br /> We will provide plan review service if you conlplete <br /> Section 5B and submit two (2) sets of plans and <br /> specifications with this application. <br /> <br /> am~ to ~ am~ <br /> amps to 1000 amps <br /> <br />(~ requitvd by Buildi~ O~clM) <br /> <br />$60.00 , 2 <br />St~0.00 2 <br />$130.00 2 <br />$300.0O -- 2 <br />$40.00 --~ 2 <br /> <br />$35.00 2 <br />$40,00 2 <br />$80.00 2 <br /> <br />$ 2.fi0 ,,. <br /> <br />$35.00 <br />$ 2.00 <br /> <br />$4~),00 2 <br />$40,00 2 <br /> <br />$40,0(I 2 <br /> <br />$35.00 ..... <br /> <br />$50.00 <br /> <br /> sq. fl, x $.06 =__ <br /># of [.~b~i~ __ _HIC , <br /> <br />FEES <br /> <br />A~. Add 5% ~u~llatge (.05 × A 1) <br /> <br />Enter 25% of line A I Iht Plan Review <br />(Sec. 3), if required <br /> <br />$ <br /> <br /> <br />