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FOR CITY USE ONLY <br />Received By: Date: <br />Zoning By: City: <br />Receipt #: Amcunt: <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete all Sections, I through 5 <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />Parcel ID: <br /> <br />PE~ITS ~ NON. T~NSFE~ AND EXPI~ IF WORK <br />IS NOT ST~T~ W~HIN 180 DAYS OF ISSUANCE OR IF I <br /> <br />Propcr~y Owner: (please p~n0 <br />Mailing Address: <br />City: State: Zip: <br /> <br />I am the PROPERTY OWNER and own, ~eside in, or will reside in <br />the completed structure and will be my own general contractor, l <br />understand that I must register a~ a construction contractor if the <br />structure is sold or offered for sale before or vpon completion, lf l <br />hire subcontractors, I will hire only subcontractors registered with <br />the Construction Contractors Board. If I change my mind and do <br />hire a general contractor who is registered with the Construction <br />Contractors Board, I will immediately notify MaCon County of the <br />name of the contractor <br /> <br /> Owner's Signature: <br /> <br />3. PLAN REVIEW SECTION <br /> <br /> Marion County does not require a plan ~eview. We will provide pian <br /> ~view sezviee if you complete Section SB and submit two (2) sets of <br />Ipans and spec fieat OhS w th th s appl cat on. <br /> <br /> MARION COUNTY BUILDING INSPECTION <br /> 3150 Lancaster Dr. NE - Suite C <br /> Salem, Oregon 97305 <br />8:00am - 4:30pm 24 HR Inspection Line 373-4427 FAX 588-7948 <br /> <br /> 4. FEE SCHEDULE (cmnpleta and enter total in Al) <br /> <br /> Number of Insp~:tions p~ permit allowed <br /> <br /> I~ Cos~ (e~h) S~ <br />1~ ~. fl. or less ~ x $110;~ = $ 4 <br /> <br /> M~ul~ Dwelling Se~i~e ~ F~ -- x $52.~ = $ <br /> R~nn~t Only <br /> <br /> ~ch brach ~wuit ~ x $3.~ = $. <br /> <br /> 2 <br /> <br />$80.00 = $ 2 <br />$130.00 = $ 2 <br />$170.00=$ 2 <br />$390.00 = $ 2 <br />$55.00 =$ 2 <br /> <br />$45,00 = $ 2 <br />$55.00 = $ --. 2 <br />$110.00 = $ 2 <br /> <br />g. FEF~ <br /> Al, Enter total of fees from Sec. 04 <br /> A2, Add state Surcharge (.05% x Al) <br /> <br />SUBTOTAL <br /> <br />B. Enter 30% of line A 1 for Plan Review <br />C. Investigation Fee (if required) <br />D. Reinspection Fee ($50.00) <br />E. Additional Plan Review ($62.50far, <br /> minimum one-half hour) <br />E Inspection for which no fee is specifically indicated, <br /> ($62.50/hr, minimum one hour) <br />G. Inspection Outside Normal Business Hours, <br /> ($62.50/hr, minimum two hours) <br />H. Industrial Plant ($62.50thr) <br /> <br />TOTAL AMOUNT DUE <br /> <br />$ <br />$ <br />$ <br /> <br />$ <br />$__ <br /> <br />MC 15-34 Rev 9/98 <br /> <br /> <br />