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FOR OFFICE USE ONLY <br />Reeeived by: 28s Church St. NE - Room 132 <br />Date: Salem, Oregon 97301 <br /> Phone 588-5147 8:0~ am - 4:30pm <br /> <br /> ELECTRICALPERMITAPPLICATION II JUN 1997 <br /> P/ease complete all Sections, I througl~ <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> <br />SITE #: <br /> <br />Date: <br /> <br />Issued by: <br /> <br />Permit No. <br /> <br />1. LOCATION OFINSTALLATION <br /> <br /> Ad- <br /> <br />PE~S ~ NON-~S~LE ~ ~ON-~AB~ ~ <br />E~E ~ WO~ IS NOT STATED ~ 180 DAYS OF ISSU~CE <br />OR ~ WO~ IS SUSP~ED FOR 180 DAYS. <br /> <br /> MARION C0UI~ <br />"' '" ...... PEI <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />2B. FOR OWNER INSTALLATIONS <br />Property Owner <br />Mailing Address Phon~ <br />City/Stat~/Zip <br /> <br />The installation is being made on property I own which is n~ intended for sale, <br /> <br />Owner's Signature <br /> <br />3. PLAN REVIEW SECTION <br /> <br />We will provide plan review service if you complete Secdon <br />5B and submit two (2) sets of plans and specifications with <br />this application. <br /> <br />This optional plan review program does not suspend the <br />required submission of lighting power calculations, plans, <br />and specifications when required by the Oregon Structural <br />Specialty Code, Chapter 53. <br /> <br />MC 15-34 8/94 <br /> <br />~t~l. FEE SCHEDULE (Complete and enter tote! in Al below) <br />T[O~ Number of Inspections per permit allowed <br /> <br /> A. R~sldential Per Unit 1 <br /> Servke Included: Items Cost (each) Sum/ <br /> <br /> 1000 sq. fl. or less $85.00 4 <br /> Each additional 500 sq. ft. <br /> or ]x)r~on tbemof $15.00 <br /> Linfitcd Enemy $20.00 1 <br /> Each Manu£d Home or Modular <br /> Dwelling Service or Feeder $40.00 2 <br /> <br /> B. Services ar Feeders (Does not ininude branch circuits, see section D) <br /> Installation, Alterations or Relocation <br /> <br /> 200 amps or less <br /> 201 amps m 400 amps <br /> 401 amps to 600 amps <br /> 601 amps to 1000 amps <br /> Over I000 amps or voPs <br /> Reconnect only <br /> <br /> C. Temporary Services/Feeders <br /> Installation, Alteration, or Relocation <br /> 200 amps orless <br /> 201 amps to 400 amps <br /> 401 amps to 600 amps <br />/~ Ove,r 600 amps or 1000 volts <br /> <br /> D. Branch Circuits <br /> New, Alteration, or Extension Per Panel <br /> <br /> a) The fee for branch circuits with <br /> ourchase of service or feeder fee <br /> <br /> Each branch circuit <br /> <br /> b) ~i~e fee for branch circuts without <br /> <br /> First branch circuit <br /> Each additional branch clr~tit <br /> <br /> E. Mtscellan~us (Service or Feeder Not Included) <br /> Each pump or irrigation circle <br /> Each sign or outline lighting <br /> Signal circuit(s) or a limited energy <br /> panel, alteration or ext~sion <br /> <br /> F. Each additional Inspection <br /> over the allowable in any of the <br /> above, per Inspection <br /> <br /> G. Minor Installation Labels <br /> Pack of 10 lebels @ $5.00 each <br /> (soM only to electrical comractorz) <br /> <br /> (Az required by Building Official) <br /> <br />$100.00 --2 <br />$130.00 2 <br />$300.00 2 <br />$40.00 2 <br /> <br />$35.00 2 <br />$40.00 2 <br />$80.00 2 <br /> <br />$35,00 <br /> <br />$40.00 2 <br />$40.00 --2 <br /> <br />$40.00 <br /> <br />$35.00 <br /> <br />$5o.oo <br /> <br />5. FEES <br /> Al. Enter total of fees from Sec. #4 <br /> A2. Add 5% surcharge (.05 x Al) <br /> <br /> Subtotal <br /> <br /> B. Enter 25% of line A1 for Plan Review <br /> (Sec. 3), if required <br /> C. Investigation Fee (ff required) <br /> D. Reinspecfion Fee ($25.00) <br /> <br /> TOTAL AMOUNT DUE <br /> <br /> Receipt No. <br /> <br />$ <br />$ <br />$__ <br />$ 7 .k <br /> <br /> <br />