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FOR CITY VALIDATION Received by: Date: MARION COUNTY BUILDING INSPECTION COMMUNITY DEVELOPMENT CENTER 285 Church St NE · Room 132 Salem, OR 97301 24 Hr Inspection Line: 588-7904 Office: 588-5147 8:00 a.m. - 4:30 p.m. FAX: 588-7948 ELECTRICAL PERMIT APPLICATION Please complete all Sections, I through 1. LOCATION OF INSTALLATION STAYTON PLANT Sob Addr~s 11598 ~ ROAD City AUMSVILLE Directions WILLAMETTE SEED CO. WEST D~cdptio, REPLACE iOOA SERVICE WITH 200A 3 phase SERVICE PERMITS ARE NON-TRANSFERABLE AND EXPIRE IF WORK IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE OR IF WORK IS SUSPENDED FOR 180 DAYS. 2A. CONTRACTOR INSTALLATION ONLY Electrical Contractorlffl~NCO ELECTRIC C4 Phone 926-4266 MailingAddr~ss PO BOX 925,ALBANliI, OR. 97321 Property Ow,er WILLAMETTE SEED CO Phone 769-2330 Contractor's License No. 22-1 5C Contractor's Board Reg~No. 49737,,.,, _[JobNo. 6/_~t'Lt- Signature of Supervising Electrici~ ~ Supervisor's License No. 3257S Phone 924-2107'--- I I 2B. FOR OWNER INSTALLATIONS Properly Owner (please prinO Mailing Addr~s I Phone City/State/Zip Owner's Signature: 3. PLANREVIBW SECTION Marion County does not require a plan review. We will provide plan review service if you complete Section 5B and submit two (2) sets of plans and specifications with this application. MC 15-34 12/94 PERMIT NO- Date: Issued by: 4. FEE SCHEDULE (Complete and eater total in Al below) A. R~idential Per Unit Nmnber of Inspections per permit allowed ~ Service Included: Items Cost (each) Sum / 1000 sq. fl. or less $85.00 4 Each additional 500 sq. ft. or portion thereof $15.00 Limited Energy $20.00 1 Each Manufactured Hoxne or Modular Dwelling Service or Feeder $40.00 ~ 2 Services or Feeders (Does not include branch circuits, see section D) Installation, Alteration or Relocation 1 50. 200 amps or less $50.00 201 amps to 400 amps $60.00 ~ 2 401 amps to 600 amps $100.00 __ 2 601 amps to 1000 amps $130.00 ~ 2 Over 1000 amps or volts $300.00 -- 2 Reconnect only $40.00 __ 2 C. Temporary serried/Feeders Installation, Alteration, or Relocation 200 amps or less $35.00 201 slaps to 400 amps $40.00 40 1 amps to 600 amps $80.00 Over 600 amps or 1000 volts see "B" above D. Branch Circuits New, Alterations, or Extension Per Panel a) The fee for branch circuits with p~of service of feeder fee Each branch circuit $ 2.00 b) The fee for branch circuits without purcha ete_of_f service or feeder fee First branch circuit Each additional branch circuit $35.00 $ 2.o0 E. Miscellaneous (Service or F~n~der No~ Inelud~l) Each pump or irrigation circle $40.00 Each sign or outline lighting $40.00 Signal circuit(s) or a limited energy panel, alteration or extension $40.00 F. Each additional Inspection Over the allowable in any of the above, per Inspection $35.00 G. Minor Installation Labels Pack of 10 labels @ $5.00 each $50.00 (sold only to electrical contractors) H. Other (As required by Building Oll~cial) Aurora Dwelling Electrical Fee Dwelling Permit Label sq.~.x$.06 =__ # of LaScls N/C FEES Al. Enter total of fees from Sec. #4 A2. Add 5% surcharge (.05 x Al) Subtotal B. Enter 25% of line Al for Plan Review (Sec. 3), if required C. Investigation Fee (if required) D. Reinspection Fee ($25.00) TOTAL AMOUNT DDE Receipt No. $.52.50