Laserfiche WebLink
FOR CITY VALIDATION[ <br />Received by: <br />Date: <br /> <br />MARION COUNTY BUILDING INSPBCTION <br /> <br />COMMUNITY DEVELOPMENT CENTER <br />285 Church St NE · Room 132 <br /> Salem, OR 97301 <br /> <br /> 24 hr. l~pectio~ Li~e 373-44?.7 <br />Office: Pholle 588-5147 8:00am - 4:30pm <br />FAX: 588-7948 <br /> <br />Date: <br /> <br />Issued by: <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete all Sections, I through 5 <br /> <br />1. LOCATION OF INSTALLATION <br /> <br /> PERMITS AR~ NON-TRAHSFERPtBLE AND F. XPlR~ IF WORK IS HOT <br /> STARTED WITHIN 180 DAYS OF ISSUANCE OR <br /> WORK IS SUSPF~NDED FOR 150 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br />Property Owner ~l~se print) <br />Mailing Address I Phone <br />Cia/State/Zip <br /> <br />3. PLAN REVIEW SECTION <br /> <br />Marion County do~s 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 />4. I~]~E SCH~}UL~ (C~nplete nad entee wtal <br /> N~ber of l~cfions p~ ~it allow~ <br /> R~d~tial <br /> ~ In~d~: lte~ ~t (eneh) <br /> <br />~ch ad~t~ 5~ sq. fL <br /> <br />~ M~ufactu~ H~e or Mo~l~ <br /> <br /> ~ am~ or in~ $50.~ <br />C. T~p~ary <br /> <br /> ~ch bran~ v~uit <br /> <br />b) Th~ fee for Inanch e/rcuits without <br /> <br />First branch ¢~uit <br />Each additional branch circuit <br /> <br />~8.oo __ <br />$ 2.oo <br /> <br />E. Miscellaneous (fi~'vine ~c Fe~dec N~ Included) <br />Each pump or irrigation circle $40.00 2 <br />Each sign or outline lighting $40.00 2 <br />Signal circuit(s) or n limited energy <br />panel, alteration or extomion $40.00 2 <br />P. Each additional Inspeetien <br />Over tbe allowable in any oftbe <br />above, per Impection $35.00 <br />O. Minor Installation Labels <br />Pack of l0 labels @ $5.00 each $50.00 -- <br />(sold only to electricz l cootr~ctors) <br />H. Other <br />(As required by lluildiog Ot~ciM) <br /> Amora Dwelling Electrical Fe~ sq. fl. x $.068 =__ <br /> Dwelling Permit Label # of Labels. N/C <br /> <br />5. FEES <br /> A 1. Eater total of fees from Sec. 84 <br /> A2. Add 5% sur~harg~ (.05 x Al) <br /> <br />Subtotal <br /> <br />B. Eater 25% of line Al for Plan Review <br />(Sec. 3), if required $.m <br />C. Investigation Fee (if required) $.__ <br />D. Reinspection Fec ($25.00) $.__ <br /> <br />Receipt No. TOTAL AMOUNT DU~ ~ $..~_~, 0 <br /> <br />MC 15-341/96 <br /> <br /> <br />