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FOR CITY VALIDATION[ <br />Re~civod by: <br />Dato: <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete all Sections, I through <br /> <br />MARION COUNTY <br />iBUILDINGINSPECTION DIVISION <br />3150 LANCASTER DR NE-SUITE C <br />SALEM OREGON 97305-1398 <br /> <br />24 h~. laspectlon Line 373-4427 <br />Office:Phone 588-5147 8:00am - 4:30pm <br />F~X: S88-7948 <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />PERMITS ARE NON-TRANSFERABLE AND EXPIRE IF WORK 1s NOT <br />STARTED WITH~ 180 DAYS OF I~SUANC~ OR IF <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />2B. FOR O'WN-J~ INSTALLATIONS <br /> <br />Marion County doe~ not requke a plan review. <br />We will provide plan review service if you complete <br />Section 5B and subaJit two (2) sets of plans and <br />specifications with this application. <br /> <br />PERMIT NO: <br /> <br />Dine: <br /> <br />Issued by: <br /> <br />4. ~TJ~]~ SC~DUL~ (Complete and ~ ~ml ~ A 1 below) <br /> <br /> ~ lnc~d~: lt~ C~t (~ch) <br /> <br />1O00 aq. fL or I~a$ S85,00 -- <br />F. ach additional 3O0 ~q. ft <br /> or po~on thereof $15.00 -- <br />Li~ttcd Eaergy $20.00 -- <br />~ach Manufactured ltmne or Modular <br /> Dwelling Scrvicc or Fe~der $40.00 <br /> <br />]~. ~t'vk~n or F~l~ I (Do~ ~ot ~nelu~ I~lll~ circuits, s~ section D) <br /> <br />D~ <br /> <br />l <br /> <br />2 <br /> <br />$100.O0 2 <br />$130.00 2 <br />$30O.00 2 <br />$40.00 2 <br /> <br />$35.00 2 <br />$40.00 2 <br />SgO.o0 2 <br /> <br />$ ZOO <br /> <br />$35.00 <br />$ 2.OO <br /> <br />$40.00 2 <br /> <br />$35.00 <br /> <br />$50,00 <br /> <br /> sq. fi. x $.068: <br /># 6r I.~:l~ N/C _ <br /> <br />A L Enter Iolal of f~ from S eo. ~4 <br />A~. Add 5% au~harg~ (.05 x Al) <br /> <br />,~abtetal <br /> <br />B. Enter 25% of line Al for Plan Review <br /> (S~. 3), if mqtsL,~l <br />C. Inv~tigagoa Fe~ (i f requlrcd) <br />D. R¢imp~tion r~c ($25.00) <br /> <br /> TOTAL AMOUbrf DUE <br /> P.~c~ipt No. <br /> <br /> <br />