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_ ,,,, ~ M'R~ION CO.UNTY BUILDING INSPECTION <br />~LO~N~ ~N~PEC~0~LECTR CAL PERMIT APPMCAT ON <br /> <br />Owner: Phon~': ..... M'~'iling Address: <br />dob Ad <br />E[~t~caJ Firm: · Phone: Address; <br /> <br />~le~rical Contractor~ ~o~ Home Builder's Registration NO.: -- <br /> <br />Supervi~ing / U~eof Residential ~ Hew ~ A~dRion ~ O~p~ .... <br />~{ectrician's~o.: ~ ~ ~uiMng; ' Com~emiel ~ Alteration ~ Reloc~tion ~ Change ~ .... <br /> <br /> No, RESIDENTIAL <br /> __ Residence wiring less then 1000 sq, ft ................................. @ $ 50,00 <br /> ___ Residencewirlnglessthan2000sq, ft ................................. @$ 75,00 <br /> __, Residence wiring ever 2000 scl, ft .................................... @ $ 105,00 <br /> __ Electric heat installation in existing residence ........................... CC. $ 30.00 <br /> SERVICES <br /> __ TemporaryConstructionService. .................................... @ $ 30.00 <br /> __ Service change only in an existing residence ........................... R $ 30.00 <br /> Commercial or Induatrial: <br /> ........ Service notover 100 amperes ....................................... R $ 45.00 <br /> -- Service over l00 amperes but not more than ;{00 amperes ................. @$ 70,00 <br /> __ Serviceover200amperesbutnotmorethan400amperes ................. RS 100.00 <br /> __ ServIceover400amperesbutnotmorethan600amperes ................. R $ 150.00 <br /> __ Ser¥1ceover600amperes ......................................... @ $ 200,00 <br /> __ Ser¥1ceover600volts ............................................. CC_ $ 450.00 <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br /> Installation of Alteratlone or Relocation of Dietribution Feeders: <br /> .... Not mere than 100 amperes ........................................ R $ 25.00 <br /> __ Overl00amperesbutnotmorethan2g0amperes ....................... @$ 40,00 <br /> __, Over200amperesbutnotmorethen400amperes ....................... RS 70.00 <br /> Over 400 amperes ............................................... R $ 85.oo <br /> __ Feederover6OOvolts ........................................... R $ 120.00 <br /> MISCELLANEOUS <br /> __ A, Eachtrailerormobilehomespece($ervtceequlpment) .................. RS 25,00 <br /> __ I~, Eachsupplyformobilehome(Connection) ........................... @$ 25.00 <br /> __ C, Eachirrigatienpump(Attachamapshowinglocatlon) ..................... ~$ 30,00 <br /> __ D, Eechelectricsignoroutlinelighting ................................ @$ 30,00 <br /> __ E, Each swimming pool(bending) ................................... R $ 30.00 <br /> BRANCH CIRCUITS <br /> / One new cimuit; alteration or extension ............................... (¢ $ 20,00 <br /> __ Twoormorenewcircuits;alteratlonsorextenslens ....................... @$ 30.00 <br /> __ Other (as per NEC end Building Official) ......................................... <br /> __ On-Site Technlcal Review (apply directly at Marion County only) ...................... <br /> __ Industrial Plant Inspection (apply directly at Marion Co[~nty enly) ...................... <br /> __ RelnspectJon Fee ................................................ R $ 20,00 <br /> FEEI l ....... <br /> STATE SURCHARGE <br /> Please return COMPLETE APPLICATION PLAN REVIEW FEE <br /> INVESTIGATION FEE <br /> with the indicated fee. <br /> FLEET SURCHARGE <br /> <br />~IGNATU RE OF APPLICANT:[ agree to make the electrical installation.~ ~Y'~_.¢.~ .-~a cording to the submitted plans and specifications, the law~ of the State of Oregon and the Ordinancee ofjo~ 1~o, ~/~/~) <br /> <br />SJGNATURE OF APPLICANT: <br /> <br /> <br />