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MARION COUNTY BUILDING INSPECTION <br />FOR CITY USE ONLY 3 ] 50 Lan3150 La~cast~r Dr. NE - Suite C <br />Rmeivcd By: Dat~: p~c[l~ ,/am~ SoL-m, Oregon 97305 <br />Zoning By: City:. - 4:30 pm 24 ~. ~ Li~e 373-4427 FAX 588-?948 <br />Reo~ip~ #: Amoum~ $. <br /> <br />ELECTRICAL PERMYr APPLICATION { ' <br />ete seeomt,laeaUSeeaons, lta.,u aS M/{fllDN 0UN] <br /> .......... <br /> <br />PERMTI~ARE NON- TRANSFEIL4BLEAND F-.XPll~R <br />WO~I~SUSPEND~ ~R 180 DAY~ <br /> <br />Co~,uamots Board No: <br /> <br />~ ~: ~lease print) <br /> <br />I am the PRO~ER~ O~ER and own, reside in, or willres~e in the <br />completed $~ucture a~ will be my own general con.actor. 1 <br /> <br />s~uctare as soM or offered for sale before or u~n complegon. ~t <br />hire subcontractors, I wiB hire on~ $ubcon~actor$ ~gistered with the <br />Cons~uctton Con.actors Board. If l change my mind and do hire a <br />general con~actor who ~ registered with the Co~tion <br />Con.actors Board, I will immediately not~ Marion Coun~ of the <br />name o/the con.actor: <br /> <br />m-ts of plato and sp~ciflcatiom with this a{~ication. <br />plan re'/~ew sec'ice ifyou complete S~-tion 5B and submit ~ (2) <br /> I <br /> <br />1000 SL Ft. ~ kss -- x $110.00 =$ 4 <br />Each Additional 500 Sq. Ft. or portion thereof x $ 20.0~ = S <br />Limit~l Emr~y x $30.00 ,=S 1 <br />Ea Manuthctot~d Hom~ or <br />b~axIul~Dwellin$Serz~c~Feeder x $ 52.00 = S..~2 <br /> <br />R, aer~kea or FecderJ (Doe~ uot iuolud~ brtnch Circui~ se~ Sectiou !)) <br /> <br />200 ~4~(x I~SS <br />201 m~ps ~0 400 ~ps <br /> <br />Ow' 1000 amps o~ vot~ <br />Reo:xm0~ Duly <br /> <br />200 am~ ~ l~m <br />201 an~s to 400 am{~ <br /> <br />Ov~ 600 ampm ~ 1000 volts, s~ "B" abow <br />D. Braa~h <br /> <br /> of S~i~ or F~"~ F~e. Ea Br Ch' <br /> b) Thc f~ f~ Ixanch ¢imui~ withou~ ~h~ <br /> <br /> First Bnmeh ¢it~ui~ <br /> Each Additional Bran~a Ci~ui~ <br /> E. Mkellaneo~ (Se~vke or Feeder Not Included) <br /> Each pump e~ ~rigation dtcle <br /> Each Si~ ~ Ondine Ligh~lg <br /> Signal Circuit(s) o~ a Limited F. aergy Panel <br /> At~oa, o~ Exto~iea <br /> F. Each Additional Inspection, over the allowable <br /> <br />G. Minor lulalla~ou Labeh <br /> Pack of I 0 labels (~ $10.00 each <br /> (S01d only to Electrical Ceatra~tm~s) <br /> IL lnd~trial Plant <br /> One/T~ Family Dwelling Fee: Sq. Feet <br /> <br /> D~elllag l'ermit Labeb (For ~ngle Family D~vetBap Only) <br /> OTHER, as required by the Building Official $ <br /> TOTAL <br /> <br />x $ 65.00 = $ 2 <br />x $ 80.00" S 2 <br />x $130.00" $ 2 <br />x $170.00 = $ 2 <br />x $390.00= $ ,, 2 <br />x $ 55,00 = $ 2 <br /> <br />x $ 45.00 = $ 2 <br />x $ 55,00 = S 2 <br /> Sl 10.00 - S...~2 <br /> <br /> $ 3.00 = $ <br /> <br /> s ~0.o0 = <br /> $ 3.00 = S <br /> <br /> $ 55.00 = $ 2 <br /> $ 55.00 = $ 2 <br /> <br /> $55.00= $ 2 <br /> $ 50.00 = $ <br /> S100.00~ S <br /> <br />$62.50/~=$ <br /> $ .09 = $ <br /> <br />5, FEES <br />Al. Enter Total Fees from Section #4 <br />A2 Add State Stun:hat'ge (.05% x Al) <br /> <br /> s z'r~'- <br />SUBTOTAL: $ 5-'-~-~-~ <br /> <br />B. Enter 30%of line Al for Plan Review $ <br />C, Invostigaflon Fee, if~.aluh-~ $ __ <br />D. R¢iml~lion Fee ($50.00) $ -- <br />E. Additional Plan Review (62,50/hr, <br />minimum on.half hour) $ ~ <br />F. inst~ction for which no fee ~s specifically indicated, <br />($62.50gu', minimum one hour) $ __ <br />G. Inspection Outside Normal Business Hours, <br />$62.50/hr, minin~um two hours) $ ~ <br />H. industrial Plant ($62.50/hour) <br /> TOT~ ~ovm VVE $ 5'7- ~-~ <br /> <br />MC 15-34 Rev 9/98 <br /> <br /> <br />