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ELEC - 1594102
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ELEC - 1594102
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Entry Properties
Last modified
10/14/2010 3:22:18 PM
Creation date
2/15/2005 12:32:20 PM
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Permits
Permit Address
8834 SHAW SQ SE
Permit City
Aumsville
Permit Number
555-99-01150
Parcel Number
082W24B 01200
Permit Type
ELEC
Permit Doc Type
Permit Document
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.................................... ] MARION COUNTY BUILDING INSPECTION <br /> I~R C~ITY. USE ONLY ~ 3150 Lancaster Dr. NE - Suite C <br /> Received By: Date: __ ~ Salem, Oregon 97305 <br />~ Zoning By; .City: ~ 8:00arn - 4:30pm 24 HR Inspection Line 373-4427 FAX 588-7948 <br /> <br />' '. ovso <br />............................. /.. :- : ~ 4~FE~ S~ltF~uLE(C6mgye~a~t~tar totalinAl) .. <br /> <br /> ELECTRICAL [ Nur%~r of inspection~ Igr p~rmit allowed-- <br /> PERMIT <br /> APPLICATION <br />I Plate all Sections, .I through 5 I : A~ ReddentialP~rUnit Sereleelneluaed: <br />~ Iteans.Cost (each) 5urn <br /> <br /> L LOCATION .OF .I~.STALLATION _ __ Eachiaddifio~ 500 sq. ft. or potion the~°f X $20.00 ~- $ ~ <br /> Parcel ID: Limited Energy -- x $30.00 -- $__ 1 <br /> <br />Site AddresS: '~ <br /> <br /> Zip: <br /> <br />Cross StreeqDirectlons: <br /> <br />IS NOT 5~.A~TED WFFHIN 180 DAYS OF ISSUANCE OR IF <br />WORKJS ~USPENDED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INFORMATION <br /> <br /> Mailing Address~ <br /> City: State: Zip: <br /> <br />Contractors :Board <br /> <br />Contracter License No.: <br />Supervisor License No.: <br /> <br /> Signature of Supervising Electrician: <br /> <br />2B. FOR OWNER INSTALLATION <br />l%oper~y Owner: <br /> <br />Each Manufactured Home or <br /> <br />B~ S~rvle~s or Feeders (Does not imlude bnmch Clreuifa, s~e s~e~ D) <br /> Installation, Alteration or Relocation <br /> 200 amps or less ~ x S65.00 = $__ 2 <br /> 201amps to 400 amps -- x $80.00=$__2 <br /> 401 amps to 6~0 amps x $130.00 = $ <br /> 601 amps to 1000 amps x $i70~00 -- $ <br /> Ovet l000 amps or volts -- x $390.00=$__2 <br /> Reconnect Only ~ x $55.00 = $ ~ 2 <br /> Insadlafioni AIteratien~, ot~ Rd~eafi0n <br /> 200 amps or less: ~ x $45.00 = $ 2 <br /> 201amps to 400 amps -- x $55.(]0=$__2 <br /> 401 amps to 60~ amps , ,, x SH0~00 = $ 2 <br /> <br />D. Branch Ci~ults <br /> New, Alfaratjon, Or Extens~)n Per Panel <br /> a} 'rig f~e for brafich ¢ircdits ~ <br /> , <br /> Each branch dir~it x <br /> b) Tl~e fee for brlnch cin:u!~ ~ <br /> <br /> First branch circuit __ x $50.00 = $ <br /> Each additional branch circuit -- x $3.00 = $ -- <br />E. M~lhm~ous (Servic~ Or Ft~der Not l~eluded) . <br /> Each pUmp or irrigation clrcie __ x $~$.00=$ <br /> Each Sign 0r Omtine Lightin§ x $~.00 = $~2 <br /> Signal Circuit(s) or a Limited Energy <br /> P~n~!,Aberationol:Ex~cnslon : -- x <br />F. Each ~ddlttonal Inspection <br />over the allowable in any of the <br />shove, per InsPection x $~0.0~ <br />G. Mtaor Installation Labels <br />Pack of 10 label~ @$ !0.00 each -- x $ lg0,~ = $ <br />(Sold only to ElectriCal Contractors) <br />Il. Industrial Plant __ x $6Z$0/hr = $ -- <br /> One/Ts~oFan~Dw~Fee:Sq. Feet -- x $ .09=:$__ <br /> OwelU.~ remit Cchels a~or Stagl~ ~mily oweln~s o~j ~/c : <br /> OTHER, as ~ quh~d by the Bdildinj Of~dal $ -- <br /> TOTAL $ <br /> <br />3. PLAN REVIEW SECTION <br />~y does not require a plan review. We wil~ <br /> review service if you complete Section 5B mad submit two (2) sets of <br /> plans and specifications with this application. <br /> <br />FEES <br /> Al. Enter total of fees from Sec. g4 <br /> A2. Add State surcharge (.05% x Al) <br /> <br />B. Enter 30% of line Al for Plan Review <br />C~ Invesfigati0n Fee (if required) <br /> <br />SUBTOTAL $ .-- <br /> $__ <br /> <br />D. Reins?ecfi~on Fee ($50.00) /~,/ / <br />E. Additional Plan Review ($62:5~, ~_t~ i ~// [ ~ ~ <br /> <br />E ~s~fion for which no f~ is s~i~fl!y in~ca~ <br />($62.50~r, ~mum one hour) $__ <br />G. Ins~tion Ou~ide No~ Business Hour, <br />(~2.50&r, ~nimum ~o ho~) $ <br />H. Indus~ Pl~t ($62.50~r) $__~ <br /> <br /> ~TAL AMO~T DUE <br /> <br /> <br />
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