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FOR CITY VALIDATION Received by: Date: MARION COUNTY BUILDING INSPItCTION COMMUNITY DEVELOPMENT CENTER :285 Church St NE · Room 132 Salem, OR 97301 24 hr. Inspection Line 373-4427 Office: Phone S~-$147 S:00am - 4:30pm FAX: 588-7948 ELECTRICAL PERMIT APPLICATION Please complete all Sections, I through ,.LOC*TION OF p~RMITS ARE NON-TRANSFERABLE AND EXPIRE IF WORK 18 NOT STAR'tF~I~ WITHIN 180 DAYS OF ISSUANCE OR IF WORK IS SUSPENDED FOR 180 DAYS. :lA. CONTRACTOR INSTALLATION ONLY 2B. FOR OWNI~ INSTALLATIONS Property Owner (ple~s~ prin0 Mailing Add~ City/State/Zip Owner's Signature: Date: Issued by: 4. FBB SCHBDULB (complel~ nnd eatar total in A 1 below) Numb~ of Inspections per permit allowed A+ Per Unit Service Included: [teton Co~t (each) Sum $000 ~1. fc ~ le~n $8~.00 Each additional 500 sq. ft. or portion thereof $15.00 Limi~d En~r g3 $20,00 Each Manufactured Home or Modular Dwelling Service or Feedee $40.00 -- B~e~der ~ (Does not include brnach circuits, see ~e~tion D) In~mn,~0r~atlun or Reloeati~ ~ ~ 200 amps or le~s ~ $50.00 ~ 201 amp~ to 400 amps $60.00 401 amps to 600 amps $100.00 601 amps to 1000 amps $130.00 Over 100~ amps or volts $300.00 Reconnect only $40.00 200 ampe or le~ t 201 amps to 400 amps ~ ~,0.00 401 amps to 600 ampa ~ $~0 Over 600 amps or 1000 volta / D. Branch Cirouits a) The fee for branch circinls wi~ Each branch eit~int ,ff $ 2.00 b) Thc fe~ for br~nch citcult~ ~ First branch circuit $35.00 -- Each additional branch cit, euit $ E. Miseelluneous ($~rviee or Feeder No~ Included) Each pump or inigation circle Each sign or outline lighting Signal clrcuit(O or n limited ener~ panel, alteration or extemion F. Each additional impmtion Over the allowable in any of the above, per Inspection O. Minor Installation Labels Pack of 10 labels @ $5.00 each (sotd only to electrical cantt~etors) H. Other (As required by Baildi~g Ot~cisl) MO.00 2 $40,00 2 $55.00 $50.00 __sq. ft. x $.068 =__ #of La. la IWC 3. FLANRBVIBW SECTION Marion County does not require a Plan review. We will provide plan review service if you complete Section 5B and submit two (2) sets of plans and specifications with this application. MC 15-34 1/96 5. FEES Al. Enter total of fees from Sec.//4 A2. Add5% surcharge (.05 xAl) Subtotal B. Enter25% of lineAl forPlunR~view (Sec. 3), if required C. lnv~afigalion Fee (if required) D. Reinspection Fee ($25,00) TOTAL AMOUNT DBE R~ceipt No.