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FOR CITY YALIDATIO) <br />Recoived by: <br /> <br />AUG 199 <br /> <br />MARION COUNTY BUILDING INSPECTION <br />COMMUNrrY DEVELOPMENT CENTER MARION COUNTY <br /> 285 c~.rc~ st NE. Room t32 pERM[~t~IJ~.iNG INSPECTION <br /> Salem, OR 97301 <br /> <br /> Dat~. <br />24 hr. Inq~ecttnn Line 373-4427 <br />Office: Phone ~88-5147 8:l~nm - 4:30pm <br />F~: s88-7~8 ~9u~ by: <br /> <br />ELECTRICAL PERMIT APPLICATION <br />P/ease complete all Sections, I through <br /> <br />L LOCATION OF IN~rALLATION <br /> <br />PERIvffTS ARE NON-TRANSt~ERABLE AND EXPIRE IF WORK IS NOT <br />STARTED WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK 15 SUSPENDED FOR 180 DAYS. <br /> <br />CONTRACTOR IN&TALLATION ONLY <br /> <br /> FOR OWNBR INSTALLATIONS <br />~l~Ferty Owner ~/e~seprim) <br /> <br />,Mailing Addr~s ] Phone <br />City/StatdZip <br /> <br />3. PLANRItVIEW SECTION <br /> <br />Marion County does not require a Plan review. <br />We will provide plan review service.if you complete <br />Sectiot', SB and submit two !2) sets of plans and <br />specifications with this application. <br /> <br />MC 15-341/96 <br /> <br />4. F~I~ SCI-J~DUL~ (Complete sad ant~t tetai ~ A1 bebw) <br /> U~ <br /> <br /> ~1 am~ to ~ am~ ~ 2 <br /> <br /> O~ 1~ amps orvo[~ ~ 2 <br /> Re~nnect only ~ , 2 <br /> <br />D. Br~neh CkeuKa <br /> <br /> n) ~e fee for brach ¢~ui~ ~ <br /> <br />b) The fee for branch circuits wiuhout <br /> <br />E. Miscellaneous (Servloe er P~d~ N~t included) <br /> ~ pump or ~n ciglo <br /> ~oh si~ or ootl~e ]ight~g <br /> Signal ciwuit(O ora ~i~d <br /> panel, alteration or ex~i~ <br /> <br /> Over t~ allowable M ~y of~e <br /> a~ve, ~r Impeetion <br />O. Min~ In~allstion ~bg~ <br /> Pack of 10 1~ ~ $~.~ <br /> (~d only to e~tric~ l commct~s) <br />H, Oth~ <br /> (~ mquired by ~ildi~ <br /> A~ra ~elfing B~t~al Fg <br /> ~elling ~it ~bel <br /> <br />$35,00 <br />$ 2,00 <br /> <br />$35~)0 <br /> <br />#ofLar~h N/C <br /> <br />5, FEES Al. Enter Wtal of fees from See.//4 <br /> A2. Add 5 % sureharg~ (.05 x A l) <br /> <br />Bubtotal <br /> <br />B. Enter 25% of li~e A 1 for Plan Review <br /> (Sec. 3), if required <br />C. Investigation Nee {if r~quired) <br />O. R¢in~pection F~ ($25.00) <br /> <br /> TOTAL AMOUNT DUE <br /> Rec¢ipl No. <br /> <br /> <br />