Laserfiche WebLink
~Reeeived by:. <br />lDate: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> 285 Church SI NE ' Room 132 <br /> Salem, OR 97301 <br /> <br /> 24 hr. Inspection Line 3734427 <br />Office: Phone 588-5147 8:00am -4:30pm <br />FAX: 588-7948 <br /> <br />ELECTRICAL PERMITAPPLICATION I <br />Please complete all Sections, 1 through 5 <br /> <br />1. LOCATION OF I~STALLATION <br /> <br />PERMITS AR~ NON-TRANSFI~RASLE AND EXPIRE IF WORK IS NOT <br />STARTF~ ~TFFI1N 1~0 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />ZA, CONTRACTOR INSTALLATION ONLY <br /> <br />2B. FOR OWI',rl~ INSTALLATIONS <br /> <br />Property Owner (please. prin0 <br /> <br />M~/ling Address ] Phone <br /> <br /> 3. PLANREVIBW SBCTION <br /> <br /> Marion County does not require a plan review. <br /> We will p[ovide plan review service if you complete <br /> Section 5B and submit two (2) sets of plans and <br /> specifications with this application. <br /> <br />MC 15-~4 1/96 <br /> <br />PERMfT NO: <br />Date: <br /> <br />Issued by: <br /> <br />4. FITE $CIrlIJ, DlJ-L[i(Compleleandenter tolalin Al below) <br /> <br /> S60.% -- 2 <br />$100.00 2 <br />$130.00 2 <br />$3120.00 _ 2 <br />$40,00 2 <br /> <br />$35.00 2 <br />$40.00 2 <br />$80.00 2 <br /> <br />$ 2. [,'~ <br /> <br />$35.00 <br />~i 2.00 <br /> <br />$35.00 <br />$50.00 <br /> <br />__~aq.fi. x $.068 = <br /># of Labels.__ ~ <br /> <br /> · 2.0 t amps to 400 amps <br /> 401 amps to 600 amps <br /> 601 amps to tO00 amps <br /> <br /> 200 am~ or less <br /> <br /> a) l~e fee for br~neh circuits ~ <br /> p~u~ase of service of feeder feat <br /> <br /> b) Th~ fee for branch circuits ~ <br /> p~3iJ~se o f service or feeder fee <br /> <br />E. Mi~ellaneou~ (~rvic~or F~ Hot [nelufl~xl) <br /> Each pump or irrigation circle ~ <br /> Each alga or outtine [igkemg <br /> Signal circuit(s) or a limited energy <br /> <br /> Over the allowable in ~yof Ihe <br /> Pack of 10 labels @ $5.00 e~ch <br /> (A~ required by Building OlEciaO <br /> <br />5. FEES Al. Emcr Iota[ o f fees from Sec. #4 <br /> A2. Add 5% surcharge (.05 x A I) <br /> <br />Subtotal <br /> <br />B, Emer 25% of line Al fotPlaa Review <br /> (Sec. 3), if required <br />C. lnvesdgatlon Fee (il'required) <br />D. Rei~pectlon Fee <br /> TOTAL A~OUNT DUE <br />Receipt I% <br /> <br /> <br />