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MARION COUNTY BUILDING INSPECTION <br /> Senator Bldg. No, 225 <br /> 220 High stn~?.NE .~-' <br /> Salem~ Oregon 97301 <br /> <br /> Phone S88~147 <br /> CoSe-A.Pnone 4:30 RM. - g:00 A,M. <br /> <br />ELECTRICAL PERMIT APPLICATION <br /> <br /> Owner: Phone: Mailing Address; <br /> Job Address: Site No.: Cross Street: <br /> 5946 WINDY RIDGE SE 97301 BROKENRIDGE SE <br /> Electrical Firm; Phone: Address: <br /> KEIZER ELECTRIC, INC. 378-0267 P.O%..B0~ 7246 .~.ALEM 97303 ..... <br /> Supervising E'lect titian '. Phone; Address: <br /> MTCHAEL WHTTTAKER <br />..... ~i~trical Contractor% NO.: ' 'Home Suilder~3 Registration NO.: <br /> 24-68C 14357 <br /> Super~i'~i'n'g Use of .... Residential [] New [] Addition n Occupancy <br /> Electrician's Ne,: 15 7 9 S Building: Commercial [] Alteration [] Relocation [] Change [~ <br /> <br /> No, RESIDENTIAL <br />____ Residence wibng less then 1000 sq. ft ................................. @ $ 50.00 <br />1 Residence wiring less than 2000 sq, ft ................................. @ $ 75.00 <br />__ Residence wiring over 2000 sq. ft .................................... @ $ 105,00 <br />__ Eiectrlc heat installation ie existing residence ........................... @ $ 30,00 <br /> SERVICES <br />__ TemporaryConstructionService ..................................... @ $ 30,00 <br />__ Service change onlyin an existing residence ........................... @ $ 30.00 <br /> Commen~ial or Industrial: <br />__ Service not over 100amperes ....................................... @ $ 45,00 <br />__ Service over 100 amperes but not more then 200 amperes ................. @ $ 70.00 <br />__ Service over 200 amperes but not more than 400 amperes ................. @ $ 100,00 <br />__ Serviceover400emperesbutnotmorethan600amperes ................. @ $ 150.00 <br />__ Service over 000 amperes ......................................... @ $ 200.00 <br />__ Service over 800 volts ............................................. @ $ 450.00 <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br /> Installation of Alterations or Relocation of Distribution Feeders: <br />__ Not morethan 100amperes ........................................ @ $ 25,00 <br />__ Overl00amperesbutnotmorethan200amperes ....................... @$ 40.00 <br />__ Overg00emperesbstnotmomthan400emperes ....................... Cc~$ 70.00 <br />__ Over400amperes ............................................... @ $ 85.00 <br />__ Feederover60gvoJts ............................................. @$ 120,00 <br /> MISCELLANEOUS <br />__ A, Each trailer or mobile home space (Service egulpmem) .................. @ $ 28.00 <br />__ B. Eachsupplyformobflehome(Connection) ........................... @$ 25.00 <br />__ C. Eachlrrlgationpump(Attaohamapshowinglocation) ..................... @$ 30-00 <br />__ D, Eachelectricsignoroutlinerlghtlng ................................ @$ 30,00 <br />__ E. Each swimming pooP (bondJng) ................................... @ $ 30.00 <br /> BRANCH CIRCUITS <br />__ One new sJmglt;alteratlon or extension ............................... @ $ 20.00 <br />____ Two or more new circuits; alterations or extensions ....................... ~ $ 30.00 <br />__ Other (es per NEC end Sullding Official) ......................................... <br />__ On-Site Technical Review (apply dlrectly at Marion County only) ...................... <br />__ Industrial Ptsnt Inspection (apply directly at Marion County only) ...................... <br />__ Relnspection Fee ................................................ @ $ 20.00 <br /> FEE <br /> STATE SURCHARGE <br /> <br />75.00 <br /> <br />75.00 <br /> <br /> Please return COMPLETE APPLICATION PLAN REVIEW FEE <br /> INVESTIGATION FEE <br /> with the indicated fee. FLEET SURCHARGE 1.2 8 <br /> TOTAL $ 8 0.0 3 <br /> <br /> agree to make the electrical Ins?a;latton acco~dJsg to the su Itted plans a ~peoifloatJons, the laws of the State of Oregon and the Ordlr~ances of Marion County. <br /> <br />~ HOMEOWNERS - I hereby certify that I am the owner of the proper~y described above, at which location I propose to make an electrical installation tor <br /> my own use end this property is not being constructed for sale, lease or rant. <br /> <br />SIGNATURE OF APPLICANT: <br /> <br /> <br />