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MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> 285 Church St NE - Room 132 <br />FOR CITY' VALIDATION Sal, ~g.97301 PERMff NO: <br /> <br />Date: 73-4427 <br /> I I~%~ Office: Phone SSg-~14~i~0am - 4:30pm __ ~ _ <br /> <br />ELECTRICAL PERMIT APPLICA'R0N '/ <br />Please complete all ~ectione, I th~l~ <br /> BUILDIN~ i~SPECTION IVumber o f lmp~ntion, p~r l~nnit allowed -'-] <br /> <br /> libras Co~t (each) Sum <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />city ~.s,f(%( (?~ <br /> <br />PER/v~ APB NON-TI~$P'F-RABLB .~ l~ IF WORK I$ NOT <br /> STARTED ~ 180 DAYS OF ISSUAI'ICE OR IF <br /> { <br /> WORK 15 SUSPENDED FOR 180 DA YS, <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />Pad(in Electric, Inc. 20250 S Molalla Ave. <br />Oregon City, OR 97045 503-657-4958 <br />Contractors License #: 34.4C <br />Supervisor: 4241.S <br />Contractors Board Reg #: 35151 <br /> <br />FOR OWNER II~TALLATION$ <br /> <br />Mailing Addrezs I Phone <br />City/State,Zip <br />Own~r'~ Signau~: <br /> <br />3. PLANP..BVIBW 8BCTION <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 />8eevie~ Included: <br />1000 aq, ft. or tess $85.00 4 <br />Each additional 500 sq. fl, <br /> or portion thel~of $15.~0 <br />Limiled Em~gy $20.00 1 <br />Each Manufactu~d Home or Modular <br /> <br />B. Se~vlee~ or F~s (Do~ not include beaneh ¢imu|~, s~ section D) <br /> <br />200 amp~ or l~s $50.00 <br />~01 amps to 400 aml~ $60.00 <br />401 amps to 600 amps $100.00 <br />~01 amln to 1000 ~ps $130.00 <br /> <br />Re~onn~ only ~0.00 <br /> <br /> 200 amps or fen $35.00 <br /> 20t aml~ to 4~0 amps <br /> 401 amps to fi00 amps $80.00 <br /> <br /> a) The fee fc~ bnmch ¢imolta with <br /> <br /> b) The fee f~ branch ¢'Lmuits without <br /> <br />E. Miaeellaneaos (~a'vi~e el' Peede~ Nat Included) <br />Each pump or irrigation <br />Each si~n or outlla~ <br />Signal clwult(s) ora limited ener~ <br />panel, alterallon or extension <br />F. ~ae~ additional <br />Over the allowable in any of the <br />above, p~r Inspection $35.00 <br />O. Min~ In~allntion <br />Pack of 10 labgla ~ $5.00 ~ach $50.00 <br />(sold only to eloctti~l co~tr~ctors) <br />H. Other <br />(As required by Building OffwiM) <br />Amora Dwelling E, tec~-ical <br /> Dwelling l~rmit Label # df Labels <br /> <br />2 <br />2 <br />2 <br />2 <br />2 <br />2 <br /> <br />2 <br />2 <br />2 <br /> <br />$ 2.00 <br /> <br />$ 2.oo <br /> <br />N/C <br /> <br />5. FEES <br /> A I. Enter tolal of fees from Sec.//4 <br /> A2, Add 5% surcharge (.05 x Al) <br /> <br />Subtotal <br /> <br />B. Enter 25% of line At for Plan Review <br /> (Sec. 3), if mqulred <br />C. Investigation Fee (ifr~quir~d) <br />D. R~inspection Fee ($25.00) <br /> <br /> TOTAL A.MOUNT DUB <br /> Receipt No. <br /> <br /> <br />