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BL,!Lg!Nr~ IM.qPFfiTlO~ IELECTRICAL PERMIT APPLICATION Please complete all ~ections, I through ~.~ff~¥~-t~Y BUILDING INSPECTION I ~1 ~o~,~ ~]~[~ DEVEL??MENT CE~R FOR CITY V~IDA~ ~--~ -~~97~Fm 132 PERM~ NO: R~eivedby: ~ III1~ ~q7 ~ ' Date: ~ ~ '~ ' ~ .... Date: ~ 24 hr. Inspection Line 373~4Z7 MARION COU~"= ~ho.~sss-s~ S=e0.m-~=SOpm F~: ~S-~4S ISSU~ by: 1. LOCATION OF INSTALLATION Cross Str~Di~tiom: PERMITS ARE NON-TRANSi~RABLE AND EX~IRE IF WORK IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE OR IF WORK IS SUSPENDED FOR 180 DAYS. 2A. CONTRACTOR INSTALLATION ONLY 2B. FOR OWNBR INSTALLATIONS Property Owner (p/e~pdat) :3. PLAN RnXq~W shcTION MariOn County does not require a plan review. We will provide plan review service if you complete Section 5B and submit two (2) sets of plans and specifications with this application. 4. F]iB SCHBDULti (Complete and enter total in Al below) A. R~idential Per UnitNumber of Inspection~ per permit allowed--] Service Included: Items Cost (each) S 1000 sq. ft. or less $85.00 4 E~ch additional 500 sq. ft. or potion fllereof $15~0 Limited Energy $20.00 1 Each Manufactured Home or Modular B. Services or Eaed~'s (Does not include branch circuits, see section D) 200 amps or less $50.00 -- 2 201 amps to 400 amps $60.00 -- 2 401 amps to 600 smps $100.00 --2 601 amps to 1000 amps $130.00 -- 2 Over 1000 mpa or volts $300.00 -- 2 Reconnect only $40.00 -- 2 200 amps or I~ $35.00 -- 2 201 amps to 400 amps $40.00 -- 2 401 ampa to 600 amps $80.00 2 Over 600 amps or 1000 rolls a) The fe~ for branch circuits w~l purchase of service of feeder fee Each branch circuit $ 2.00 -- b) The fee for branch circuits without purchase of service or feeder fee First branch circuit I Each additional branch circuit l Each pump or irrigation circle Each sign or outline lighting Signal circuit(s) or a limited energy panel, alteration or extension F. Each additional Inspection Over thc allowable in any of the above, per hlspection O. Minor Installation Labels Pack of l0 labels @ $5.00 each (sold oMy to electricM contruetors) H. Other (As required by l~Jilding O~ciaO Aurora Dwelling Elec~cal Fee Dwelling Permit Label Mineellaneous (Sefvioe or Feede~ Not Included) $35.003~~ $ 2.0o ~_2t $40.00 7. $40.00 2 $40.00 2 $35.0O -- $50.00 __sq. fi. x $.068 =__ #of Labels N/C 5. FEES A 1. Enter total of fees from Sec. g4 A2. Add 5% surcharge (.05 x Al) Subtotal B. Enter 25% of line Al for Plan Review (Sec. 3), if required C, Investigation Fee (if required) D, Reinspeetion Fee ($25.00) TOTAL AMOUNT DUE Receipt No.