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FOR CITY VALIDATION <br />Received by: <br />Date: <br /> <br />MARION COU1VrY BUILDING INSPECTION <br />COMMUNITY DEVELOPMENT CENTER <br />285 Church St NE · Room 132 <br /> Salem, OR 97301 <br /> <br /> '~ 24 hr. lnspecnon Line 373-4427 <br /> Office: Phone 588~147 8:OOam - 4:30pm <br /> FAX: $88-7948 <br /> <br />IELECTRICAL PERMIT APPLICATION <br />Please complete all Sections, 1 through 5 <br /> <br />1. LOCATION OF INffrALLATION <br /> <br />rczd 4- Eac_ <br /> <br />ARE NON-TRANSFERABLE AND EXPIRE IF WORK I$ NOT <br />STARTleD ~ 1~0 DAYS OI: ISSUAN~ OR l~ <br /> WORK I$ SUSPENDED FOR 180 DAYS. <br /> <br /> CONTRACTOR INSTALLATION ONLY <br />m~dcslC°"~¢mrCHERRY CITY ] R'°e~3997609 <br /> <br /> ELECTRIC <br />Malliag^dd~ POB 12668, Salem <br /> <br />co.~¢mr's L/o~,~ No. 37- 620 C <br /> <br />Con~ctor',Soard~,s. No. 91668__ <br /> <br />$ignalu~ of Supervialng <br /> <br /> FOR OWNER IHSTALLATION8 <br /> <br />Pro~y Owne~ ~le~, prir~) <br /> <br />Mailing Addr~s ] Phone <br />City/$tateJZip <br />Ovn,.~'s Signal, us, c: <br /> <br />3. PLANP. EVIHW 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 15-34 1/96 <br /> <br />PERMIT NO: <br /> <br />Date: <br /> <br />Issued by: <br /> <br /> Installation, Alteeatien or Re[oealie~ <br /> 200 amps or I~ $50.00 <br /> 201 amps to 400 amp~ $60.00 <br /> 401 amps to fi00 amps $100.00 <br /> 601 amps to 1000 ~ps $130.00 <br /> Over 1000 amps or volta saoo.0o <br /> Reconnect only $40.00 <br /> <br />C. Temporary 8ervleea/Feednra <br />Installation, Alteration, er Reloeatioa <br />200 stops or leto $35.00 <br />201 amps to 400 amps $40,00 <br />401 amps to 600 amps $80.00 <br />Over 600 amps or 1000 volt~ <br /> <br />O. Braneit C~r~ulte <br /> New, Alteeat[ons, or Rxtsnalon p~ Panel <br /> a) The i~ for branch cimui~s ~ <br /> <br /> Each branch e/rcui~ $ 2,C0 <br /> <br /> b) The fee foe bemch circuits without <br /> i <br /> First brmach circuit $35.00 <br /> Each additional branch circuit I $ 2.00 <br /> <br />lt. MiseeUaneoun (S~vice w Fe~l~' Not laduded) <br />Each pump of i~iptlon cireJ~ $40~0 <br />Each sign or outline lighting $40.00 <br />Signal circuit(s) or a limited energy <br />panel, alteration or e~tenaloa $40.00 <br />P. Each additional l~ect'mn <br />Over Ih~ allowable in any of the <br />· b~ve, p~z I~spectlon $~5~0 <br /> <br />P.¢k o£ l0 label. ~ $5.00 e~:h $~0.00 <br />(sold only to electr/cal eomractora) <br />H. Otbe~ <br />(As requited by Buil~ng O~cial) <br />Aurora Dwelling ~cMcal F~ vq. fl, x $.068 = <br /> Dwelling Permit Label it of Labels. <br /> <br />5. FEES <br /> A 1. Enter total of feea from Sec, #4 <br /> A2. Add5% surcharge (.05 x Al) <br /> <br /> <br />