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· ' MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> 285 Church St NE · Room 132 <br />] FOR CITY.,¥A!qlDATIOI5[[ Sal-m OR 97301 PERM[T NO: <br /> by: <br /> <br /> ELECTRICAL PERMff APPLICA~ <br /> Pl~e complete ~l ~tions, I through ~q~tn <br /> <br />PERMITS ARE NON-IRANSFERABLE AND EXPIRE IF WORK lS NOT I <br /> STARTF~D V~]'THIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR 180 DAYS, <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />Electrical Contractor <br /> <br />Phoru~ <br /> <br />Property <br /> <br />Signature of Supervising Electrician <br />Supervisor's License No. <br /> <br />lob No. <br /> <br />Phone/$ I <br /> <br />liB. FOR O~ INSTALLATIONS <br /> <br />PLAN RBVIBW 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 15-341/96 <br /> <br />Each additional 500 sq. ft. <br /> ~ portion the, mol $25.00 <br />Limited Energy $20.00 .. 1 <br />Each Manufactured Home or Modular <br /> <br /> 200 fimps or less $50.00 -- 2 <br /> 201 amps to 400 amps $60.00 2 <br /> 401 amps to O30 ~nps $100.00 2 <br /> fi01 ampsto 1000amps $130.00 __2 <br /> Over 1000 amps or volts $300.00 2 <br /> Reconnect only $40 J00 2 <br /> <br /> 200 amps or less $35.00 2 <br /> 201 amps lo 400 amps $40.00 .. 2 <br /> 401 amps to 600 amps $80.00 2 <br /> Over 600 amps or 1000 volts <br /> <br />D. Br*~ <br /> New, Alt~ratkn~ m' nxt~n~ion pet Panel <br /> <br /> Each branch ¢imuit '-[ $ 2.00 <br /> b) The lc* for bt~¢h ¢imui~ ~ <br /> <br /> First branch circuit $35.00 <br /> Each additional b~onck circuit $ 2,00 -- <br /> <br />E. Mi~ellanemis (8~vio~ or P~lm' No~ Include) <br /> <br /> ~ch si~ or outline li~t~g $~.~ 2 <br /> Si~fl e~t(s) ora ~ited <br /> ~nel, alteration or extem~ ~.00 2 <br /> <br />G. Min~ Inat~Eation ~b~ <br /> ~¢k of 10 labela ~ $5.~ ~ch $~,~ <br /> <br />H. Oth~ <br /> (~ req~d by ~ildi~ O~c~O <br /> Au~ ~elli~ Ethereal F~ ~xq. fi. z <br /> ~elling Pe~it ~bel <br /> <br />5. FEES Al. Enter total of fees from Sec. <br /> A2. Add 5% su~hat~ (.05 x A t) <br /> <br />Subtotal <br /> <br />B. Enter 25% of lln~ Al for Plan Review <br /> (Sec. 3). if required <br />C~ Inv~tigation Fee (if required) <br />D. Reimpectiou Fe~ ($25.00) <br /> <br /> 0¢7 *<5L <br /> AIVIOUNT <br /> DUB <br /> <br /> <br />