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F~R CIT~ USE ONLY <br />Received By: --Date: <br />Zoning By: City: <br />Receipt ~ Amount: $ <br /> <br /> ELECTRICAL PERMIT APPLICATION <br /> Please complete all Sections, 1 through 5 <br /> <br />L LOCATION OF INSTALLATION <br /> <br /> Paw~l ID: <br /> <br />~ross Str~ilDir~tions: <br /> <br />Project Description: <br /> <br />PERMITS ARE NON-TRANSFERABLE AND EXPIRE IF WORE <br />IS NOT STAR~'ED WITHIN 180 DAYS OF ISSUANCE OR IF <br />WOP. E IS SUSPENDED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INFORMATION <br /> <br /> 3-tq fi <br /> <br />2B. FOR OWNER INSTALLATION <br /> <br />Property Owner. (please print) <br />Mailing Addl'ezs: <br />City: State: Zip: <br /> <br />I am the PROPERTY OWNER and own, reside in, or will reside in <br />the completed structure and will be my own general contractor. I <br />understand that I must register as a construction contractor if the <br />structure is ~old or offered for sale before or upon completior~ 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 />Contractor~ Board, I will immediately notify Marion County of the <br />name of the contractor. <br /> <br />Own~'s Signature: <br /> <br />3. PLAN REVIEW SECTION <br /> <br /> Marion County does not require a plan review. We will provi~ plan I <br /> review service if you complete Section 5B and submit two (2) se~s of <br /> I <br /> plans and specifications wi~h this application. I <br /> <br /> MARION COUNTY BUILDING INSPECTION <br /> 3150 Lancaster Dr. NE - Suite C <br /> Suiem, Oregon 97305 <br />8:00am - 4:30pm 24 HR Inspection Line 373-4427 FAX 588-7948 <br /> <br /> FEE SCHEDULE (complete and anter total in Al) <br /> <br />Panel, Ai~ration ~r Extension x $55.00 = $ ~.~U2 <br />Each admtional Inspection <br /> <br />OuetrwoFamllyDvn~agFee:Sq. Feet -- x $ .09=$__ <br /> <br />OTHER, as required by the Building Official $ -- <br /> TOTAL $ -- <br /> <br />5. FEES Al. Enter total of fees from Sec. #4 <br /> A2. Add State Surcharge (.05% x Al) <br /> <br />B. En~r 30% of line A1 for Plan Review <br />C. Investigation Fee (if required) <br />D. Ruiaspection Fee ($50.00) <br />E. Additional Plan Review ($62.50/hr, <br /> minimum one-half hour) <br />F. Inspection fur 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. Indusuial Plant ($62.50/hr) <br /> <br />TOTAL AMOUNT DUE <br /> <br />$__ <br />$ <br /> <br />MC 15-34 P~v 9/98 <br /> <br /> <br />