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FOR CITY VALIDATION[ <br />Received by: ] <br />Date: [ <br /> <br />MARION COUNTY BUILDING INSPECTION <br />COMMUNITY DEVELOPMENT CENTER <br />285 Church St NE · Room 132 <br /> Salem, OR 97301 <br /> <br />24 Hr Inspection Line: 588-7904 <br />Office: 588-5147 8:00 a.m. - 4:30 p.m. <br />FAX: 588-7948 <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete all Sections, I through <br /> <br />'Directions <br /> <br /> \ <br /> <br />PERMITS ARE NON-TRANSFERABLE AND EXPIRE IF WORK IS NOT <br />STARTED WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br /> 2A. CONTRACTOR INSTALLATION ONLY <br />' EleclricalContra~!.~'~ ~ ~'~ <br /> <br /> I <br /> <br />Contractor's Board Reg. No. q~9 '3 3 [ JobNo. <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br />Property Owner (ple~tse print) <br />Mailing Address t Phone <br /> <br /> City/State/Zip <br /> <br /> Owner's Signature: <br /> <br />3. PLANREVIEW SECTION <br /> <br />Marion County does not require a plan review. <br />We will provide plan review service if you complete <br />Section 5B and submit two (2) sets of plans and <br />specifications with this application. <br /> <br />PERMIT NO: <br /> <br />Date: <br /> <br />Issued by: <br /> <br />4. 17~E SCHBDUL~ (Complete and enter total in A1 below) <br /> Number of Inspections per permit allowed <br />A. <br /> Rmidential <br /> Per <br /> Unit <br /> ! <br />~brvioo Included: Items Cost (each) Sum <br />1000 sq. ft. or less $85.00 4 <br />Each additional 500 sq. ft. <br /> or portion thereof $15.00 <br />Limited Energy $20.00 1 <br />Each Manufactured Home or Modular <br /> Dwelling Service or Feeder $40.00 ~ 2 <br /> <br />$orvim or F~dera (Does not include branch circuits, see section D) <br />Installation, Alteration or Relocation I $50.00 ~'~2 <br />200 amps or less <br />201 amps to 400 amps $60.00 ~ 2 <br />401 amps to 600 amps $100.00 ~2 <br />601 amps to 1000 amps $130.00 ~2 <br />Over 1000 amps or veils $300.00 -~ 2 <br />Reconnect only $40.00- __ 2 <br /> <br />C. Temporary 8ervicedFeedera <br />Installation, Alteration, or Relocation <br />200 amps or less $35,00 <br />201 amps to 400 amps $40.00 <br />401 amps to 600 amps $80.00 <br />Over 600 amps or 1000 volts <br />see "B' above <br />D. Branch Circuits <br />New, Alterations, er Extension Per Panel <br />a) The fee for branch circuiis with <br />purchase of service of feeder fee <br />F. ach branch circuit $ 2.00 <br /> <br />b) The fee for branch circuits without <br /> purchase of service or feeder fee <br />First branch circuit <br />Each additional branch circuit <br /> <br />$35.00 <br />$ 2.00 <br /> <br />E. Miscellaneous (Service or Feeder Not Included) <br />Each pump or irrigation circle $40.00 ~ 2 <br /> Each sign or outline lighting $40,00 2 <br />Signal circuit(s) or a limited energy <br />panel, alteration or extension $40.00 ~ 2 <br />F. Each additional Inspection <br />Over the allowable in any of the <br />above, per Inspection $35.00 ~ <br />O. Minor Installation Labels <br />Pack of 10 labels ~ $5.00 each $50.00 ~ <br />(sold only to electrical contractors) <br />H. Other <br />(As required by Building Official) <br />Aurora Dwelling Electrical Fee <br />Dwelling Petrait Label N/C <br /> <br />__ sq. fi. x$.06 = ~ <br /># of Labels <br /> <br />A 1. Enter total of l~es from Sec. <br />A2. Add 5% surcharge (.05 x Al) <br /> <br />Subtotal $.~ <br /> <br />B. Enter 25% of line A1 for Plan Review <br /> (Sec. 3), if r~quir~d <br />C. Investigation Fee (if required) <br />D. Reinspection Fee ($25.00) <br /> <br />TOTAL AMOUNTDUE <br /> <br />Receipt No, <br /> <br />MC 1,~-34 12/94 <br /> <br /> <br />