Laserfiche WebLink
FOR CITY VALIDATION <br />Received by: <br />Date: <br /> <br />MARION COUNTY BUILDING INSPBCTION <br />COMMUNITY DEVELOPMENT CENTER <br />285 Church St NE · Room 132 <br /> Salem, OR 97301 <br /> <br /> 24 hr. Inspection Line 373-1427 <br />Office: Phone 588-5147 8:00am - 4:30pm <br />FAX: $88-7948 <br /> <br />PERMIT NO: <br /> <br />Date: <br /> <br />Issued by: <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete all ~ections, I through 5 <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />.'obAddress 8948 DARLY RD SE <br />cay AUMSVILLE Ic'uss s~ <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br />Elec~calC°nh'ac~r~T, ELECTRIC; l~h.°~e 391-911 3 <br />Ma~mgAadr~, 581 LANCASTER DR SE STE 50 <br /> <br />l~op~rty Owrgr [ Phone <br /> <br />Contractor's License No. 24-269C <br />Comractor's Board Reg. NO. 1 0 9 4 3 2 I Job No. <br /> <br />Sup~r~i~or'sLlccnaeNo. 2481S { Phon~ 391 -911 3 <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br />Ptope~y Ownar ~/eas~pdnt) <br /> <br />3. PLAN RBVIBW SBCTION <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 />MC 15-341/96 <br /> <br />4. FBE SCHEDULE (Complet~ snd ~t~ lo'mi ~ Al ~w) <br /> <br /> Unit <br /> ~ Inelud~: ~ ~t (ench) S~ <br /> <br />~ch Mdit~n~ 5~ sq. ~. <br /> <br />B. ~ ~ P~s ~s ~t ~lode ~ch ci~i~ s~ sect~ D) <br /> <br /> Re~ct only ~.~ ~ 2 <br /> <br />D. Bran~ Circuits <br /> <br /> a) ~e fe~ f~ b~ch ~ ~ <br /> p~e of semite of fe~er f~ <br /> ~ brach ci~uit $ Z~ <br /> <br />b) The fee for branch ¢ircuils ~ <br /> <br />$35.~ -- <br />$2.~ <br /> <br />E. Misoellan~a (Servi0~ ~ F~n~d~- N~ ln~ud~) <br />~ch p~p <br />~ ai~ or outl&o li~g ~,~ 2 <br />Sign~ c~a) or n I~it~ en~ <br />p~et, ~t~f,~ or ex~on ~.~ -- 2 <br />F. ~ a~it~l In~m~ <br />~ert~ allowable in any of~e <br />a~, ~r ~ction $35.~ <br />O. Min~ In~a~ti~ Labe~ <br />Pack of 10 <br />(~d oMy to elec~ical co. factors) <br />H. 0~ <br />(~ ~ui~d by Boildi~ O~ci~O <br /> <br />Aurora Uwelliag Ele~ical Fe~ ~q. fl. x $.068 = -- <br />Dwelling Permit Label tt of Labela__ N/C <br /> <br />Al. Entertotaloff~fmmS~,/bl, $. 40.00 <br />A2. Add 5% surcharg~ 605 x Al) $2.00 <br /> ~ubtotal $ <br /> <br /> (Sec. 3), ifxequired $.__ <br />D. Rcimpoctioa Fee (S25,~0) $.__ <br /> TOTAL AMOUNT DUE $. 42.00 <br /> <br /> <br />