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Received iBy: __ <br />Date: _ <br /> <br />MARIOI~ COUNTY BUILDING INSPECTION <br /> <br /> reet NE <br /> S~lem, Oregon 97301 <br /> <br /> Code-A-ehone 4:30 P.M. - 8:ua A.M. <br /> <br />ELECTRICAL PERMIT APPLICATION <br /> <br />Mailing Address;-- ,, , <br /> <br />Cross Street: <br /> <br />Phone: <br /> <br />Address: <br /> <br />Address: <br /> <br />Home Builder's Registration No,; <br /> <br /> I Use of Residenllel [] New [] Addition L~ Occupancy <br />Electrician's NO.:,~., ~, // $ Building; Commercial [] Alteralton [] Relocation [] Change [] <br /> <br />No. RESIDENTIAL <br /> <br /> ____ Residence wiring less than 1000 sg. ft ................................. (itl $ <br /> Residence wiring less than 2000 sq. ft ................................. ¢? $ 75,00 <br /> __ Residence wiring over 2000 eq. ¢t .................................... ([¢ $ 105.00 <br /> ........ EJectdc heat installation in existing residence ........................... f[,~ $ 30.00 <br /> SERVICES <br /> .... Temporary Construction Service ..................................... (a~ $ 30.00 <br /> __ Service change only in an existing residence ........................... (~> $ 00,00 __ <br /> Commercial or Industrial: <br /> ....... Servlcenotoverl00emperes ........ ............................... (~$ 45.00 __ <br /> --- Serviceoverl00emperesbutnetmorethan200amperes ................. .)$ 70,00 <br /> , Service over 200 amperes but not more than 400 amperes ................. (~:~ $ 100.00 <br /> --- Servlce over 400 smperes but not more than 600 amperes ................. ({;.'$ 150,00 <br /> __.. Service ever 600 amperes ......................................... (¢~)$ 200.00 <br /> Servlceover 800volts ............................................. (~¢ $ 450,00 <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br /> Inetallation of Alterations or Relocation of Distribution Feeders: <br /> -- Not more then l00 ~mperee ........................................ (q~$ 25,00 <br /> __ Over 100 amperes but not more than 200 amperes ....................... (~ $ 40.00 <br /> ....... Over gOO amperes b~t not more than 400 smperes ....................... (~? $ 70,00 <br /> ...... Over 400 amperes ............................................... ~$ 85,00 <br /> FeederoverC00vofts ............................................. ¢~ $ 120.00 __ <br /> MISCELLANEOUS <br /> A. Eachtrailerormobilehomespace(Serviceequipmeng .................. ¢~ $ 25.00 <br /> __ B, Each supply for mobile home (Connection} ........................... (i~~ $ 25,00 <br /> ..... C. Eechirdgationpemp(Attachamapshowinglocation) ..................... (t£'$ 30,00 <br /> .... D, Each electric sign or outline lighting ................................ (h' $ 30.00 __ <br /> .... E. Each swimming pool(bonding) ................................... ~ $ ,30,00 <br /> E~RANCH CIRCUITS <br /> __ One newcircult; alteration or extension ............................... ((~' $ 20,00 <br /> ....... Two or more new circuits; alterations or extensione ....................... (~ $ 30.00 <br /> -- Other (as per NEC and Building Official) ..... , ................................... <br /> -- On-elto Technical Review (apply dlrectly at Marion County only) ...................... <br /> -- Industrial Plant Inspection (apply directly at Marion County only) ...................... <br /> --.__ Relnspection Fee ................... : .'.'. ......................... (u, $ 20.00 __ <br /> FEE <br /> STATE SURCHARGE <br /> Please return COMPLETE APPLICATION PLAN REVIEW FEE <br /> with the indicated fee. INVESTIGATION FCE <br /> FLEET SURCHARGE <br /> TOTAL ..... <br />~ electrical insta~tion according to the submitted plans and %peolflcallons, the la,Es of the State of Oregon and the Ordinances of M~rion County. <br />SlGNATU,EOFAP.LIOANT, ~,~¢~ /~/L ~013 NO, <br /> -'] HOMEOWNERS - I hereby certify 1hat I am the owner of the property described abc:c, at which location I propose to make an electrical installation for <br /> my own use and this property is not being constructed for sale, lease or rent. <br /> <br />SIGNATURE OF APPL CANT <br /> <br />MC 15-34 (Owner doing hi~ Own work) <br />Rev, 12/88 <br /> <br /> <br />