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.................................... ] MARION COUNTY BUILDING INSPECTION <br /> FOR crrY USE ONLY , 3150 Lancaster Dr. NE - Suite C <br /> Received By: .Date: ~ Salem, Oregon 97305 <br /> Zoning By: _City: ~ 8:00am - 4:30pm 24 HR Inspection Line 373-4427 FAX 588-7948 <br /> <br />................................. ~ .... . : . : 41 FEE $~ULE (complete and ~nter to~i In Al) <br /> ELECTRICAL PERMIT APPLICATION ] Numar of ;,SPecti°ns m pe~t allowed <br /> Please complete all Sect~,ns, I through $ ] . A; Resideml~l P~r unit SelMee included: <br /> ~ 1000 sq; fit 0rleS~ X $110~00 = $ 4 <br />1. <br /> LOCATION <br /> Each additional 500~. ~t: or l~X~ion thereof x $20,00 = $ <br /> <br />Parcel ID: <br /> <br />Limi(~d Energy x $30.00 = $_ 1 <br />Each Manufactured Home or <br /> M°dularDWeili~gScrvi~toeede(~ -- x <br />B. Servtees 0r Feeder~ (Dhe~ ~t Inchide branch Clmfl~, see section D) ' <br /> Ir~tallation, Alteration or Relocation <br /> 200 amps or less -- x $65.00 = $ 2 <br /> 201amps to 400 amps -- x $80.~0=$ 2 <br /> 401 amps to 600 amps x $130.00 = $ ~2 <br /> <br /> Over 1~00 amps or volts -- x $390.~0 = $ 2 <br /> Reconnect Only~ : , x $55,00 ~ $ 2 <br /> <br />: Inst~atioi~, ~,ltmaio~ 4/. Ra~ea~ · ' <br /> <br /> 201 amps to 400 amps -- x $~5.00 = $ 2 <br /> 401amps to 60O amps . ~ x $110.00=$ . 2 <br /> Over:600 amps or 1000 volts s~e "B' above <br /> <br /> New Alan, 0r Exlum~oR Per Panel <br /> <br /> ~u~ha~ of S~rvi~ ~ F~er F~ 0 <br /> First branch circuit / x $50.00 -- $~'~ <br /> <br /> PERMITS,ARE NON-TRANSFERABLE A2VD EXPIRE IF WORK ~ <br /> IS NOr STARTED WITHIN !80DAYS OF ISSUANCE OR IF ] <br />] WOS~ ~S. S~S~ ~O~SO VAVS' , ,] <br />2A. CONTRACtoR ORMATION . <br /> <br />Prope~y Owner: (please print) <br />Mailing Address: : : : <br />City: State: 'Zip: <br /> <br />I am~ the PROPERTY OWNER and own, reside i~ or will reside in <br />the Completed strUcture and will be my own general contractor. I <br />understand that I must register as a con~truction contractor if the <br />structure is sold or offered for sale before or t~pon completion. If 1 <br />hire subcontractors, I will hire only subcontractors registered with <br />the Construction Contractors Board. If l change my mind and do <br />hire a general contractor whe is registered with the Construction <br />Contractors Board, I will immediately notify Marion County of the <br /> <br />Owner's SignatUre: ' · <br /> <br />3. PLAN REVIEW SECTION <br /> <br /> Marion County does not r~luire a Plan review! W~ will provide plan <br /> review service if you complete Section 5B and aubmit ~Wo (2) sets of <br /> plans and sl~cifications with this applicmion. ~ <br /> <br />MC 15-34 Rev 9/98 <br /> <br />EachSign or O~ttine Lighting <br />Signal Gircuit(s) or a Limi~t En~ <br /> <br />omfrwo Fanaly Oweuam re~: Sa, ~ <br /> <br />-- x :$55.00=$ 2 <br />· x $55.00=$ , , 2 <br /> <br />-- x $50.00=$ : <br /> <br />---- x $100,00 = $ <br /> <br />-- x $62.50/hr = $ __ <br />-- x $ .09=$ <br /> <br />· ' Dwelling permit La~els (For Single Family DwelUngs Only) N/C <br /> O'I'tlER, as reqult~d by the Building Official $ -- <br /> ToTAL ' $ . <br /> <br /> suBTOTAL $ <br /> <br />B. Enter 30% of line A~ for Plan Review $ __ <br />C. Investigation Fee (if required) $ <br />D, Reinspection Fee ($50.00) $__ <br />E. Additional Plan Review ($tZ50/hr, <br />minimUm one-half hour) - $ , <br />E Inspection for which no fee is specifically indlcated,: ~ <br /> <br />($62.$0/hr, minimum one hou0 $__ <br />G. Inspection Outside Normal Business Hours, <br />($62.50/hr, minimum two hours) <br />H. Industrial Plant ($62.50~r) <br /> <br />5. FEES Al. Enter totai of fees from <br /> A2. Add State SUrCharge (.05% x Al) <br /> <br />TOTAL AMOUNT DUE <br /> <br /> <br />