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MARION COUHTY BUILDING INSPECTION r i 285 church st NE. Room 132 PERMIT NO.. ' FOR CITY VALIDATION Salem, OR 97301 Reoeiv~d by:, I DO. tO: ~-~d~, ~. ~ ~ q~p Date: 24 hr. Inspection Line 373-4427 Office: Phone 588-5147 8:00am - 4:30pm FAX: 588-7948 [$SUOd by: ELECTRICAL PERMIT APPLICATION Please complete all Sections, I through ~ ARE NON-TRANSI~RABLE AND EXPIRE IF WORK IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE OR IF WORK IS SUSPENDF~ FOR 180 DAYS. 2A. COHTRACTOR INSTALLATION oNLy Electrical Contractor J l~one Mailing Address l~opeay Owner Conlrector'a License No. Contractor's Board Reg. No. Signatore of Supervising Elec~cian J Phone Supervisor's License No. I Phone 2B. FOR OWNtLR INSTALLATIONS 3. PLANREVIEW SECTION Marion County does not require a plan review. We will provide plan review service if you complete Section 5B and submit two (2) sets of plans and specifications with this applicafon. MC 15-341/96 4. I~E 5CHEDULB (Complete and enter total in Al below) Number of Inspections per Permit allowed Rmidzntial Per Unit ! Service Included: Iten~ Co~t (each) Sum 1OOO ~q. fL or less $85,00 Each additional 5430 sq. ft. o~ poaion thereof $15.00 Limited Energy $20,00 ~.1 Each Manufactured Home or Modular /,,~Dwelling Service or Feeder $40,00 ~ 2 · ~ Feeders (Does not include branch circuits, see section D) L.-'"-~'~-ila~on, Alterati°n or Reinoation 200 amps or leas ~ - ,~ fs $50.00 ~ 2 201 amps to 400 amps $60.00 ~ 2 401 amps to 600 amps $100.00 ~2 601 amps to loo0 amps $130.00 ~2 Over IOO0 amps or volts $300.00 ~ 2 Reconnect only :M0.00 ~ 2 C. Temporary Services/Feeders Installation, Alteration, or Reloeation 200 amps or less 201 amps to 400 amps 401 amps to 600 amps Over 600 amps or loo0 volts ~ee "B" above D. Branch Circuits New, Alterations, or Extortion Per Panel a) The fee for branch circuits ~ purchase of service of feeder fee Each branch circuit $35.00 __ 2 M0.00 ~ 2 SS0.00 __ 2 $ 2.00 b) The fee for branch circuits wilhout purchase:of service or feeder fee Fu~t branch circuit Each additional branch circuit $35.bo $2.OO 2 ,2 2 E. Mi~dlaneoua (8orviee or Feeder Not Included) Each pump or irrigation circle M0.OO Each sign or outline lighting $40.00 Signal circuit(a) or a limited energy panel, alteration or extension $40.00 F. Each additional Inspection over the allowable in any of the above, per Inspection $35.00 (31. Minor Installation Labels Pack of 10 labels @ $5.00 each $50.00 (sold only to electrical contractors) H. Other (As required by Buil~ng Official) Aorora Dwelling Electrical Fcc Dwelling Permit Label sq. ft. x $. 068 = ~ # of Labels N/C 5. FEES A 1. Enter total of fees from Sec.//4 $ A2. Add 5% surcharge (.05 x Al) $.~ ~btotal B. Enter 25% of line A 1 for Plan Review (Sec. 3), if required $ __ C. Investigation Fee (if required) $.~ D. Reinspection Fee ($25.00) $ TOTAL AMOUNT DUE Receipt No.