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Received By: <br />Date; <br /> <br />MARION COUNTY BUILDING INSPECTION <br />Senator eldg, No. 225 <br />220 High Street NE <br /> <br />ELECTRICAL PERMIT APPLICATION <br /> <br />  Phone: ......... Mailing Address: "' <br /> <br /> JobAddress:' ! ' - <br /> Phon~: <br /> ,,~[dress', <br /> <br /> Electrical Contracto~ No~ I 'Home ~uilder's Registration No.; ,~' <br /> <br /> Supervising I Useof ........ Residential ~ New [] ~ Addition [] Occupancy <br />__l~lectrician~ _N~..~ ...~J Building: Commercial ~. J.,,.~l!?~a!!?n,[;~~- Relocation [] Change <br /> <br />NO, <br /> <br /> RESIDENTIAL <br />__ Residence wiring lessthan 1000sq, ft ................................. @ $ 50,00 <br />-- ResldencewiringleSsthan2000sq, ft ................................. @$ 75.00 <br />__ Residence wiring over 2000 sq. ft .................................... @ $ 10,5.00 <br />-- Electric heat installation in existing residence ........................... @ $ 30,00 <br /> SERVICES <br />__ Temporary Construction Service ..................................... @ $ 30.00 <br /> Service change only in an existing residence ........................... @ $ 30.00 <br /> Commerelal or Industrlah <br />__ Service not over 100 amperes ....................................... @ $ 45,00 <br />__ Service over 100 amperes but not more than 200 amperes ................. @ $ 70.00 <br />__ Serviceover200amperesbutnotmorethan400amperes ................. @$ 100.00 <br />__ Serviceover400amperesbutnotmorethanB00amperea ................. @ $ 150,00 <br />__ ServlceoverS00amperes ......................................... @ $ 200.00 <br />,__ Servlceover600volts ............................................. @ $ 450,00 <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br /> Installation of Alteratlona or Relooation of Distribution Feeders: <br />___ Not more than 100amperes ........................................ @ $ 25,00 <br />__ OverlOOampereabutnotmorethan2OOamperes ....................... @$ 40,00 <br />__ Over200amperesbutnotmorethan400amperea ....................... @$ 70.00 <br />__ Over 400 amperes ............................................... @ $ 85.00 <br />__ Feederover600volts ............................................. @$ 120,00 <br /> MISCELLANEOUS <br />__ A, Each trailer or mobile home space (Service equipment) .................. @ $ 25,00 <br />__ B. Each supply for mobile home (Connection) ........................... @ $ 25.00 <br />__ C. Eachirrigationpump(At~achamapshowJnglocation) ..................... @$ 30.00 <br />____ D. Eachalectdcsignorout[inelighting ................................ @$ 30,00 <br />__ E, Each swimming pool (bonding) ................................... @ $ 30.00 <br /> BRANCH CIRCUITS <br />__ Onenewcircult;alterationorextenslon ............................... Co)$ 20.00 <br />__ Twoormorenewclrcults;altaratlonsorextensions ....................... @$ 30.00 <br />__ Other (as per NEC and Suiiding Official) ......................................... <br />__ On. SiteTechnJcaIReview(appiydirectlyatMadonCountyonly) ...................... <br />-- Industrial P~ant Inspection (apply directly at Marion County only) ...................... <br />__ Reinspemion Fee ................................................ @ $ 20.00 <br /> FEE <br /> STATE SURCHARGE <br /> <br /> Please return COMPLETE APPLICATION PLAN REVIEW FEE <br /> with the indicated fee. INVESTIGATION FEE <br /> FLEET SURCHARGE ':':'~-~, <br /> TOTAL $ <br /> <br /> Cou~. <br />SIGNATUREOFAPPL~CANT- ~ ~/~ ~ ~O~ <br /> HOMEOWNERS - I hereby certi~ that I am the owner of the pmper~escdbed above, at which location I propose to make an electrical installation for <br /> my own use and this property is not being constructed for sale, Ieee or rent, <br /> <br />SIGNATURE OF APPLICANT: <br /> <br />MC 15-34 (Owner deing his own work) <br />Rev, 12/88 <br /> <br /> <br />