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FOR CITY VALIDATION <br />Received by: <br />Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br />COMMUNITY DEVELOPMENT CENTER <br /> 285 Church St NE · Room 132 pr:RMff NO: <br /> Salem, OR 97301 <br /> <br /> DRte: <br /> 24 hr. Inspection Line 373-4427 <br />Offtee: Phone 588-5147 8:00am - 4:30pm <br />FAX: 588-7948 [~$uod by: <br /> <br />I ELECTRICAL PERMIT APPLICATION [ <br />Please complete all ~ectiot~$, I through 5 4. FEB SCHI[DULE (Complete and ent~' total ia ^i below) <br /> Number of Inspections per p¢rmit allowed <br /> <br /> 1000 sq. ft. or less $S5.00 <br /> <br />~bAd4~ SW Corner of Aumsville-Shaw Highway <br />cay Aumsville Ic~ <br />Dimc~om at Highway 22 <br /> <br />l~ipfi~ Temporary service <br /> <br />PERMITS ARE NON-TRANSFERABLE AND EXPIRE IF WORK IS NOT <br />STARTED WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPI~DED FOR 180 DAYS. <br /> <br /> CONTRACTOR INSTALLATION ONLY <br />Beck,al Contractor Linnco Electric ] Ph~e 926-4266 <br />MailingAddre~ ~0 BOX 925, Albany OR ::97321 <br /> <br /> Contractor's Lic~me No. 22-15C Date: 10/29/96 <br /> ConUaetor'a Board Reg. No. 49737 [ ~ob No. 61738 <br /> Signature o f Supervisiag Eleclfi¢i~/~ <br />I Su.rvisor'sLic*nsoNo. 3257S I Ph~ee 9~6-4266 <br /> <br />2B. FOR OWNBR INSTALLATIONS <br /> <br />Proi~ty Owner (ple~ts~ print) <br /> <br />Muiling Addr~s I Phone <br />City/gtate/Z/p <br />Owner's Signature: <br /> <br /> 3. PLAN RBVIEW SECTION <br /> <br />IMarion 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 t/96 <br /> <br />Each additional 500 sq. ft. <br /> or portion thereof $15,00 <br />l~mited Energy $20.00 1 <br />Each Manufactured Home or Modular <br /> Dwelling Service or Feeder $40.00 -- 2 <br /> <br />B. Servieee or Feeders (Does not include branch circuits, see section D) <br /> <br /> 200 amps or leas $50.00 2 <br /> <br /> 200 amos or less i $35.003 5 · 002 <br /> <br /> 401 amps to 600 amos $80.00 2 <br /> <br /> Each branch clreuit 3 $ 2.00 6..0Q <br /> <br />b) The fee for branch circuits without <br /> · '¢ <br />First branch circuit <br />Each additional brmmh circuit <br /> <br />R. Mi~llaat~us (Se~vi~ ~' Fe~d~r ~ lu~ud~) <br /> ~ch pump or i~igation oircle <br /> ~¢h si~ or oufliae li~t~g <br /> Si~al c~uit(s) ora ~igd <br /> <br />F. Ea~ addit~al in~ian <br /> <br /> Pack of 10 l~els ~ $5.~ ~ch <br /> (sold only to electrics I contractors) <br />H. 0~ <br /> <br /> A~ra Dwelli~ El~cal <br /> <br />$35.00 <br />$ 2.00 <br /> <br />$40.00 2 <br />$40.00 2 <br /> <br />$35,1[}0 <br /> <br />$50.00 <br /> <br />__~vq. fl. x $, 068 = <br /># of Labels <br /> <br />5. FEES <br /> A 1. Enter total of fees from See. fi4 <br /> A2. Add 5% surcharge 605 x Al) <br /> Subtotal <br /> <br /> B. Enter25% oflifleAl for Plan R~view <br /> (Sec. 3), if r~quired <br /> C. Investigation Fee (if r~quired) <br /> D. Reinspectian Fee ($25.00) <br /> <br /> TOTAL AMOUNT DUE <br /> Receipt No. <br /> <br />$ 41 <br />$. 2,05 <br /> <br />$ <br /> <br />%43.05 <br /> <br /> <br />