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MARION COUNTY BUILDING INSPECTION <br />FOR OFFICE USE ONLY <br />RecgjvedOl~: 220 High Street NE <br />Date: Sale. Oregon 97301 <br /> Phon~ <br /> -~1~: -~ IT Permit No <br /> <br /> ELECTRICAL PERMIT APPLICAT ON ' <br /> Please complete all Sections, 1 through 5 ] ~,.,. o ~ ~qq7 Issued by: __ <br /> MARION Cntl~. .,, <br /> BUILDIN I .... <br /> L LOCATIONOFINSTALL&T1ON ~ ~.~i~q~ULE(Comple~andontertotalm^lbelow) <br /> <br />City I Cros~ St. <br />Directica~ s <br /> <br />Descriptlc~ <br /> <br />EXPIRE IF WORK IS NOT STARTI~ WITHIN 180 DAYS OF ISSUANCE <br />OR IF WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />Pmpa~ty Owner [ Phone <br />Contractoffs License No. <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br />Property Owner <br /> <br />Mailing Address Phone <br />City/State/Zip <br /> <br />The installation is being made on property I own which is not intended for sale, <br /> <br />Owner's Signature <br /> <br />3. PLAN REVIEW SECTION <br /> <br />We will provide plan review service if you complete Section <br />5B and submit two (2) sets of plans and specifications with <br />this application. <br /> <br />This optional plan review program does not suspend the <br />required submission of lighting power calculations, plans, <br />and specifications when required by the Oregon Structural <br />Specialty Code, Chapter 53. <br /> <br />MC 15-34 11/91 <br /> <br /> Number of Inspections per petanlt allowed <br /> <br />A. <br /> Residential <br /> Per <br /> Unit <br /> S~'vlce Included: Items Cost (each) Sum/ <br /> <br />1000 sq. ft. ~less $85.00 <br />Each addliionel 500 sq. ft. <br />or poffion tbereof $~5.00 <br />Limited Energy $20.00 <br />Each Manu£d Home or Modular <br />Dwal]ing Se~icc or Feeder $40,00 <br />~, Services Or Feeders (Does not irdcude branch c~ rcuits, see s~tion Di* <br /> 200 amps or less <br /> <br /> 201 amps to 400 amps <br /> 401 amps to 600 ampa <br /> 601 amps to 10~0 amps <br /> Over 1000 anps or vohs <br /> Reconnect (rely <br /> <br />C. Temporary Services/Feeders <br /> lnstalintlo~ AIt~atina, or Relocation <br /> 2~0 amps or less <br /> 201 amps to 400 amps <br /> 401 ampa to 600 amps <br /> Ovgr 6~O amps or 1000 volts <br /> <br />D, Branch Circuits <br /> New, AIt~ation, or Exteaslon Per Panel <br /> <br /> a) Thc f~ for branch circuits with <br /> mtrchase of scr,4ce or feeder <br /> <br /> Each branch circuit <br /> <br /> b) Thc fee for branch circuts without <br /> ~urchase of service or feeder fe~ <br /> <br /> F'~st branch cincuit <br /> Each additional branch circuit <br /> <br />E. Miscellaneous (Service or Feeder Not Included) <br /> Each tromp or irrigation circle <br /> ' ~'Each signor oudinc lighting ' <br /> Signal circuit(s) or a limited energy <br /> panel, alteration or extension <br /> <br />F. Each additional Inspectio~ <br /> over the allowable in any of the <br /> above, per Inspection <br /> <br />G. Minor Iastallatina Labels <br /> Pack of 10 labels ~ $~.00 each <br /> (~ot~ oaly ~o electrical co~tr~ctor$) <br /> <br />H. Olher <br /> ( ~ r~q~ir~d by Baild~n# Offici~0 <br /> <br /> t50.00 ~ 2 <br /> 60.00 2 <br />$100.00 2 <br />$130.00 2 <br />$300.00 2 <br />$40.00 2 <br /> <br />$35.00 2 <br />$40.00 2 <br />$80.00 2 <br /> <br />$35.00 <br /> $2.00 <br /> <br /> $40,00 2 <br />-- $40.00 -2~ <br /> <br />$40,00 --2 <br /> <br />SSO.oo <br /> <br />5. FEES <br /> Al. Eater total of fees from Sec. #4 <br /> A2. Add 5% surcharge (.05 x Al) <br /> <br /> Subtotal <br /> <br /> B. Enter 2~% of line A1 for Plan Review <br /> (Sec. 3),if required <br /> C. Investigatio~ F'ee (if required) <br /> D. Reinspection Fee ($25.00) <br /> <br /> TOTAL AMOUNT DUE <br /> <br />$ <br />$ <br /> <br /> <br />