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FOR CITY VALIDATIONl <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 />P/ease complete all Sections, I through 5 <br /> <br />1. LOCATION OF INSTALLATION <br /> <br /> ADD. SS i-$ j <br /> <br />DIRECTIONS <br />PROJECT DES CP~PTION dC~'a tv '~, <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 /> Property Owner (please print) <br /> <br /> Marling Address <br /> <br /> City, State, Zip <br /> <br /> Owner's Signature <br /> <br />3. PLAN REVIEW 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 />PERMIT NO:~'~/~ <br />Date: <br /> <br />Issued by: <br /> <br />A. Residential Per Unit <br /> Service Included: <br />1000 sq. ft. or less <br />Each additional 500 sq. ~. <br /> <br />4. FEE SCHEDULE (Complete and enter total in A1 below) <br /> <br /> $85.00 4 <br /> <br /> $15.00 <br /> I $20.00 1 <br /> <br /> $40.00 2 <br /> Services or Feeders (D~es not include braneh circdil$~ see section D) <br /> <br />Installation, Alteration or Relocation <br />2fl0 amps or less $50.00 2 <br />201 amps to 400 amps $60.00 2 <br />401 amps to 600 amps $ I00.00 2 <br />601 amps to 1000 amps $130.00 __ 2 <br />Over 1000 amps or volts $300.00 2 <br />Reconnect only $40.00 2 <br /> <br />Other <br />(As required by Building Officials} <br /> <br />Aurora Dwelling Electrical Fee <br /> <br />Dwelling Permit Label # of LaEals __ <br /> <br />5. FEES Al, Enter total of fees from Sec. #4 <br /> A2. Add 5% surcharge (,05 x Al) <br /> <br />B. Enter 25% of line A1 for Plan Review <br /> (Sec. 3), if required <br />C. Investigation Fee (if required) <br />D, Reinspection Fee ($25.00) <br /> TOTAL AMOUNT DUE <br />Receipt No. __ <br /> <br /> <br />