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FOR CITY USE ONLY Recei',~d By:. Date: Zoning By: City: Receipt #: Amount: ELECTRICAL PERMIT APPLICATION Please complete all See~ions, I through 5 LOCATION OF INSTALLATION IS NOT ~ ~N 180 ~YS OF I~U~ OR IF WO~ IS S~PE~ ~R 180 D~Y~ 2~ CON~CTOR ~FO~TION Property Owner: (please prinO Mailing, ^dthess: City: State: Zip: I am the PROPERTY O~ER and own, reside in, or will reside in the completed structure and will be my own general contractor. 1 understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion, lf l hire subcontractors, I will hire only subconlractors registered with the Construction Contractors Board. lf l change my mind and do hire a general contractor who is registered with the Construction Contractors Board, I will immediately notify Marion CounO/ of the name of the contractor: 3. PLAN REVIEWSECTION plan review service if you completa Sectkm 5B and submit tv, o (2) sets of plans and specifications with this application. , MARION COUNTY BUILDING INSPECTION 3150 Lan3150 Loncaster Dr. NE - Su'~ C Salem, Oregon 97305 8.'00 am - 4:30 pm 24 hr. Inspection Line 373 -4427 FAX 588-7948 FEE SCHEDULE {complete and enter total in Al) Number of Inspe~ions per ~ allowed-- A. Residential Per Unit, Service Included Items Cost (each) Sum 1000 St. Ft. or Igs~ x $110.00 =$ Each Additional 500 Sq. FL or portion thereof x $20.00 =$ Limit~l Energy x $ 30.00 = $ 1 Ea Maon~ctur~ Hon~ or Modular Dv,~.lingSeotio:or Fc~dar __ x $52.00 -= $____2 B. Servle~s or Feeders (Does not include branch Circuits, aec Section D} Instellation, Alteration, or Relocation i 200ampsor ¢s$ / . x $65.00 ~ 201 amps to 400 aml~ x $ g0.00 ~ $ 2 401 amps to 600 amps x $130.00 ~ $ 2 601 amps to 1000 amps x $170.00-- $ 2 Ov~ 1000 amps o¢ volta x $390.00 ~ $ 2 R~a:mn~tOnly x $ $5.00== $ 2 C. Temperar}' Servieea/Feeders InstaRation, Alterations, or Re~ocation 200am~cl~ss x $45.00 =' $ 2 201 anv~to400aml~ x $55.00 ~ $ 2 401 amps to 600 amps x $110.00-' $ 2 Over 600 amps oc 1000 volts, s~¢ ~B' above D. Branch Clreulta a) the fee for branch circuits with the nurchase ofS~'iceorF~derF~F, aBrCir x $ 3.00 ~ $ b) The fee for bnmch circuits without ~rchase of Service or Feeder F~e: Fi~ Branch C~R x $50.00 =, EachAdditJo~alBnmchCireuit x $ 3.00 ~ $ E. Miscellaneous (Service or Feeder Not Included) Each Sign or Outline Lighting x $ 55.00 = $ 2 Signal Circuit(s) or a Limited Energy Panel, Alteration, of Exte~on × $55.00-- $ 2 F. Each Additional Inspection, over the allowable in any of the above, per inspection x $ 50.00 ~ $__ G. Minor Installation Labels Pack of 10 labols (~ $ I 0.00 each x $100.00~ $ (Sold only to Elec~cal Contractors) H. Industrial Plant x $62.50 / hr ~ $ One/TwoFamilyDwelling Fee:Sq. Fee~ x $ .09 ~$ Drilling Permit Labels (For Single Family D~ellings Only) N/~ OTHER, as required by the Building Official $__ TOTAL 5. FEES Al. Enter Total Foes fi'om Section//4 A2 Add State Surcharge (.05% x Al) SUBTOTAL: B. Entor 30%of lineAl forPlan Review C. Investigation Foe, ifr~quimd D. Reinspoetion Foe ($50.00) E. Additional Plan Review (62.50/hr, minimum one-half hour) F. Inspection for which no foe is specifically indicated, ($62.50/hr, minimum one hour) G. Inspection Outside Normal BusIness Hours, $62.50/hr, minimum two hours) H. lnduslrial Plant ($62.50/honr) TOTAL AMOUNT DUE $ $ $ $ $ $ lZ6.00 MC 15-34 Rev 9/98