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MARION COUNTY BUILDING INSPECTION <br />] FOR. OFFICE USE ONLY { CO~D~WmPM~rr c~r-~ <br />] Received by:. 2S5 C~urch St. N~ - Room 132 <br />Date: Salem, Or~on ~301 <br /> <br />ELECTRICAL PERMIT APPLICATION ~ · <br />~,o,~e cor,~,o,o,,,, so~,o,, ,h~ough ~ Issued by: <br /> <br />L ~c~oN OF~ST~,LATIONrA \%~D <br /> <br />pERM1TS ARB NON-TEANSFERABLB AND NON-EBFUNDABL8 AND <br />EXP]RB IF WORK IS NOT STARTED wI'rH]~ 180 DAYS O¥/SSUANCE <br />OR IF WORK IS SUSPI~TDED FOR 180 DAYS. <br /> <br />SA. CONTRACTOR ~NSTALLATION ONLY <br /> <br />2B. FOR OWNER INSTALLATIONS <br />Pw~e~y Owner <br /> <br />Msflins Add~css Phone <br /> <br />~ The/nstslladon is being m~de o~ properS' I own whlah is mx in'ed for sale, <br />'~ Owaets Si~rmmm <br /> <br />3. PLAN REVIEW SECTION <br /> <br />We will provide plan review service if you complete Seclion <br />5B and submit two (2) sets of plans and specifications with <br />thi~ application. <br /> <br />This optional plan review program doe~ not suspend the <br />required submission of lighting power calculatlons; plans, <br />and Sp¢C~t'lcatiOI1S when required by the Oregon Structural <br />Special~y Cede, Chap~r 53. <br /> <br />MC 15-34 8/94 <br /> <br /> Imtallago~ AIt~aUoas ~ Rdoca#on <br /> 20O amps c~ less <br /> <br /> ~ ~t~ ~ Rd~a~on <br /> ~or~ <br /> <br /> ~er ~ ~ps or l~ v~ <br /> <br />D. ~ C~I~ <br /> <br />E. ~n~(~ ~F~er Not Included) <br /> <br />G. MI~ ~HaUon <br /> Pack d 10 h~ ~ ~.~ ~ <br /> (soM ~y m ~l~c~al co~ractors) <br /> <br />H. O~ <br /> ( ~ mq~r~ ~ B~8 <br /> <br /> I50.00 , 2 <br /> 60.0O ,.. 2 <br />$100.00 2 <br />$130.00 .... 2 <br />$300.00 2 <br /> <br />$40.00 <br />$80.00 2 <br /> <br />$2.00 <br /> <br />$.~.oo <br /> $2.0o <br /> <br />$40.00 .. 2 <br />$40.00 ... 2 <br /> <br />$40.00 2 <br /> <br />$35.00 <br /> <br />$50.00 <br /> <br />Rece/~x No. <br /> <br /> Number of Inspections pm' permit allowed ,-~ <br /> <br />A. <br /> I <br /> <br /> 100O sq. fl. 0~' I~S $8~.00 4 <br /> <br /> ~- ,m mere~ $20.00 1 <br /> ~~ $15.00 <br /> <br /> ~ M~d H~e ~ M~ <br /> ~ ~ ~ ~ $40.00 2 <br /> <br /> B. ~F~ ~ ~ ~ ~ ~u, ~ ~ D) <br /> <br /> <br />