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FOR CITY Vd~ATION <br />Received By: <br /> <br />Date: <br /> <br /> MARION COUNTY <br />BUILDING INSPECTION DIVISION <br />3150 Lancaster Dr. NE - Suite C <br /> Salem, Oregon 97305-1398 <br /> <br /> 24 HR Inspection Line 373-4427 <br /> Office: phone 588-5147 8:00am - 4:30pm <br /> FAX 588-7948 <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete all Sections, 1 through 5 <br /> <br />1. LOCATION OF INSTALLATION <br /> <br /> JOB ADD.SS <br /> <br /> PROJECT DESC~ON <br /> <br /> PERMITS ARE NON-TRANSFERABLE AND EXPIRE IF WORK IS NOT <br /> STARTED WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br /> Owner*, pr , ac <br /> Mailing Address ~/ ~ J~ , ~ <br /> <br /> Phone, Islol a=l Iz[ el l/I gl717 <br /> <br />3. PLAN ~W SECTION <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 />MC 15-34 7/97 <br /> <br />A. Residential Per Unit <br /> Service lnduded: <br />1000 ~q Iff . or less <br />Each additional 500 sq. it. <br /> or portion thereof <br />Lindted Energy <br />Each Manufactured Home or <br />Modular Dwelling Se~ice or Feeder <br /> <br />4. FEE SCHEDULE (Complete ~d enter total ~ Al ~Iow) <br /> $;t~ts °f Inspe25S(e~ bT=it ~2ed ~ <br /> <br />Installation, Alteration or Reloeation <br />200 amps or less $50.00 ~ 2 <br />201 amps to 400 amps $60.00 __ 2 <br />401 amps to 600 amps $100.00 __ 2 <br />601 amps to 1000 amps $130.00 __ 2 <br />Over I000 amps or volts $300,00 2 <br />Reconnect only $40,00 2 <br /> <br />5. FEES <br /> All Enter total of fees from S ~ l ~ <br /> su~haxge (.05 x Al) <br /> A2. <br /> Add <br /> 5% <br /> <br /> Subtotal <br /> <br /> <br />