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~ FOR. CITYVALIDATION <br /> Recemvedby: <br /> Date: , <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br />COMMUNITY DEVELOPMENT CENTER <br />285 Church St NE - Room 132 <br /> Salem, OR 97301 <br /> <br /> 24 hr. Inspection Linc 373-4427 <br />Office: Phone 588-5147 8:00am - 4:30pm <br />FAX: 588-794B <br /> <br />IELECTRICAL PERMIT APPLICATION <br />Please complete all Sections, I through 5 <br /> <br />L LOCATION OF INSTALLATION <br /> <br />c~ l ~° £//'t~ ~ ~ . <br /> <br /> bmpg. , , <br /> <br /> ~S A~ NON-~S~B~ AND ~l~ ~ ~ lS NOT <br /> <br />STARTED ~ 1~0 DAYS OF ISSUANCE OR IF <br />WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />Phoneff <br /> <br />2B. FOR OWNBR INSTALLATIONS <br /> <br />Properly Owner (plezsoprint) <br />Mailing Addr~s / !uhcn~ <br />City/State/Zip <br /> <br />3. PL~ ~EW S~TION <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 />Date: <br /> <br />Issued by: <br /> <br />4, FEE SCHEDULE (Complete and ~ut~ total itt A t <br /> Unit <br /> <br />1~ sq. fl. or less $85.~ ,4 <br />Limited ~er~ ~ $20.'~ <br /> <br /> $50.00 -- 2 <br />$60.00 2 <br />$100.00 2 <br />$130.00 2 <br />$300~0 __2 <br />$4O.00 2 <br /> <br />$35.00 2 <br />$4O.00 2 <br />$80.00 2 <br /> <br />$ 2.00 -- <br /> <br />~eedee fee <br /> <br />$35.00 -- <br />$ 2.00 -- <br /> <br />E. Miscellaneous (Se~vlco or Feeder Not Included) <br />E~¢h pump or kfigation cirri= $40.~ 2 <br />~ch si~ or outline li~ting ~.~ 2 <br />Si~al c~uit(s) or a l~fited en~ <br />p~d. alt~ti~ or exte~i~ ~.~ 2 <br /> <br /> ~er the allowable in any of ~ <br /> <br /> ~ek of 10 labe~ ~ $5.~ ~ch $~.~ <br /> <br /> sq. fi. x $.068 = <br /># of Lab*Is. <br /> <br />' 5. FEES <br /> At. Emer total Of fees imm See, #4 <br /> A2, Add 5% surcharge (.05 x Al) <br /> ~btotal <br /> <br /> B. ~ter25% oflineAI for Plan R~iew <br /> (See. 3). if requi~d $.~ <br /> C. ~v~tigation Fee (if ~d) $,__ <br /> D. Re~pection F~e ($25.~) <br /> <br /> TOT~ ~O~ DUE <br /> R~eeipt No. <br /> <br /> <br />