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Received By; <br />Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br />220 Hi,ih Street NE <br /> <br /> Phone $88~147 <br /> <br />ELECTRICAL PERMIT APPLICATION <br /> <br /> ~ P~ne'. Mailing Address:' , ~ <br /> <br /> Job Add,ss: I , ~ '"/ ~lte No, ~¢~ Cross Street'. <br /> <br />~r~i~ng EleCtrician; Phone: - dross: <br /> <br /> Electrical Contractor~ No.: ~ Home Builder's Registration No.: ' <br /> <br />~upervising ~ U~e of Residential ~ New ~ Addition ~ O~up~'~'c~ <br /> Elemrician's NO~ Building: Commemlal ~ Alteratio~ Relocation ~ Change <br /> <br />NO. <br /> <br /> RESIDENTIAL <br /> Residence wiring less than 1000 sq, ft ................................. @ $ 50.00 <br /> Residence wiring less than 2000 sq, ft ................................. @ $ 75,00 <br /> Residence wiring over 2000 sq, ft .................................... @ $ 105.00 <br /> Electris heat installation in existing residence ........................... @ $ 30,00 <br /> SERVICES <br /> Temporary Construction Service ..................................... @$ 30.00 <br /> Service change only in an exietlng residence ........................... @$ 30.00 <br />Commercial or Industrial: <br />Service eot over 100 amperes ....................................... @ $ 45.00 <br />Service over 100 amperes but not mere then 200 amperes ................. @$ 70.00 <br />Serviceever200amperesbut notmorethan400ampems ................. @ $ 100.00 <br />Service over 400 amperes but not mom then 600 amperes ................. @ $ 150.00 <br />Service over 600amperes ......................................... @ $ 200.00 <br />Service over 600 volts ............................................. @ $ 450.00 <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br />Installation of Alterations or Relocation of Distribution Feeders: <br />Not more than 100 amperes ........................................ @ $ 25.00 <br />Over 100 amperes but not more than 200 amperes ....................... @ $ 40.00 <br />Over 200 ~mperes but nm more than 400 amperes ....................... @$ 70.00 <br />Over 400 amperes ............................................... @$ 85.00 <br />Feederover600volts ............................................. @ $ 120.00 <br /> MISCELLANEOUS <br />A. EechtreHerormobilehomespece(Serviceequfpmen0 .................. @$ 25.00 <br />18. Each supply for mobile home (Connection) ........................... @ $ 25.00 <br />C, Each irrigetloe pump (Attach a map showing location) ..................... @ $ 30,00 <br />D. Eachelectricsignoroutllnelightlng ................................ @$ 30,00 <br />E. Eachswimmingpool(bonding) ................................... @ $ 30,00 <br /> BRANCH CIRCUITS <br />One new circuit; alteration or extension ............................... @$ 20,00 <br />Two or more new olmults; alterations or extenslons ....................... @$ 30.00 <br />Other (as per NEC and Building Official) ......................................... <br />On-Site Technical Review (apply directly at Marlon County only) ...................... <br />Industrial Plant Inspection (apply directly at Marion County only) ...................... <br />Reinspectioe 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 /> ,EET SURG.^.GEToTAL <br /> <br />HOMEOWNERS - I hereby ce~i~ that I am the owner of the prope~ described above, et which location I propose lo make an electrical installation for <br /> <br />S~GNATURE OF APPLICANT;. <br /> <br />MC 15-34 (Owuer doing bJsown wo~k) <br />Rev. 12/88 <br /> <br /> <br />