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FOR CITY VALIDATION] <br />Received by:.___.._.__.__ <br />Date:~ <br /> <br />MARION COUNTY BUILDING INSPECTION <br />COMMUNITY DEVELOPMENT CENTER <br />285 Church St NE · Room 132 <br /> Salem, OR 97301 <br /> <br />24 Hr Inspection Line: 588-7904 <br />Off'~.e: 588-5147 8:00 a,m. - 4:30 p.m. <br />FAX: 588-7~48 <br /> <br />IELECTRICAL PERMIT APPLICATION ] <br />Please complete all Sections, I through 5.~ <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />pERIv~TS ARE NON-TRANSFERABLE A~D EXPIRE IF WORK IS NOT j <br /> <br />STARTED WITHIN 180 DAYS OF ISSUANCE OR IF <br />WORK I$ SUSPENDED FOR 1 ~0 DAYS. <br /> <br /> CONTRACTOR INSTALLATION ONLY <br /> <br />Supe i,or', ,, o o. cjT b <br /> <br />213. FOR OWNIlR INSTALLATIONS <br />Pmpeny Owner (ple~aeprim) <br /> <br />Mailing Address '~ Phone <br /> <br />City/State/Zip <br /> <br />Owner's Signatm~: <br /> <br />3. PLANREVIBW SBCTION <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 />PERMIT NO: <br /> <br />Date: <br /> <br />Issued by: <br /> <br />4. ~ ~CH~DUL~ (Complete and enter total in A1 below) <br /> Number of Inspections per permit allowed <br />A. <br /> Resid~ntiel <br /> P~ <br /> Unit <br /> ~rvio~ineluded: Items Coat(each) Sum I <br /> 1000 sq. fL or le~ $g5.00 4 <br />Each addiliona1500 sq, fL <br /> or portion thereof $15.00 <br />Limited Energy $20.00 1 <br />Each Manufactured Home or Modular <br /> Dwelling Service or Feeder ,$40.00 -- 2 <br /> <br />B. $e~¥iee~ ~' F~a (Doe~ not include branch circui~ see section D) <br /> InataEation, Alteration e~ Relocation <br /> 200 amps or less $~0.00 <br /> 201 amps to 400 amps $60.00 -- <br /> 401 amps to 600 amps $t00.00 2 <br /> 601 amps to 1000 amps $130.00 <br /> Over 1000 amps or veils $300.00 -- <br /> Reconnect only $40.00 -- 2 <br /> <br />C. Temporary ~ieea/P~ste~s <br /> <br /> 200 amps or les~ ] $35,00 2 <br /> 201 amps to 400 amps $40.00 <br /> 2 <br /> <br /> Over 600 amps or 1000 volts <br /> <br />D. I~aneh <br />New, Al~aratlons, or Extension Per Panel <br />a) The fee for btanoh cimuils with <br /> / <br /> Each branch circuit $ 2.00 / -- <br /> <br />b) The fee for branch circuits without <br /> <br />First braach circuit <br />Each additional branch oireuit <br /> <br />$35.00 <br />$ 2.00 <br /> <br />E. Mis~anneous ~srviee or Feede~ Nd Included) <br /> Each pump o~' ~gation cirqe ' ~[0.00 , 2 <br /> Ench sign or outlin~ lighting ~ $40.00 2 <br />Signal oi~uit(s) ora limited energy <br />panel, alteration or zxl~nsion $40.00 -- 2 <br />F. Eneh additional Innpeetion <br />Over the allowable in any of the <br />above, per Inspection $~5.00 __ <br />O. Minor Installation Labels <br />Pack of 10 labels 0 $5.00 each $50.00 <br />(sold only to electrical contractors) <br />H. other <br />(.a.s reqnired by Building Ol~*ial) <br />Aurora Dwelling Electrical F~ sq. E. x $.06 -- -- <br />Dwelling Permit Label # of Labels N/C <br /> <br />5. FEES <br /> Al+ Enter total of f. ee_~ Sec. ~ <br /> A2. Add 5% .ufo .I~I~AI) .bt.I <br /> <br /> (s~. 3), if ~ <br /> C. Inv~tigntbn ~fmq~) <br /> D. ~pection Fee ($25.~) <br /> <br /> ~T~ ~O~ D~ <br /> ~t No. <br /> <br /> <br />