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FOR CITY USE ONI~Y ~,n~h~- ~-.~ s-- R ts---m-n. 31~ ~ ~. ~ - Suite C <br /> _ ) <br /> ~ ~ ~ ..... , ' ~ ~ -J:3~m ~ ~ ~s~on Line 373~27 <br /> <br /> JUN 1999 <br />...................................... --~ -- :~. ~E S~E (~p~ aM e~r ~ la Al) <br /> <br /> ELECT~CAL PE~ ,~ <br /> APPLiCATiO~, MARION COUND <br /> <br />1. LOCATION OF INSTALLATION <br />Parcel ID: <br /> <br />city: ~_ ~r_~.. zip: <br /> <br />PERMITS ARE NON. TRANSFERABLE AND EXPIRE IF WORE <br />IS NOT STARTE~ WITHIN 180 DAYS OF ISSUANCE OR IF <br />WORE IS SUSPENDED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INFORMATION <br /> <br /> Contractor: <br /> <br />Mailing Addmss: <br /> <br />City: <br /> <br />State: Zip: <br /> <br /> ~ontractors Board No.: <br /> <br />Contractor Liceme No.: <br /> <br />Sup~visor License No.: <br /> <br />Signature of Supe~ising Electrician: <br /> <br />2B. FOR OWNER INSTALLATION <br /> <br /> Mailing Address: ~.-10'~3 ~ I~E{'"~, <br /> On, zip: <br /> I am the PROPERTY O~31ER and own, reside in, or will reside in <br /> the cotapleted stracture and wilt be my own general contractor. <br /> understand that I must register as a construction contractor O'tbe <br /> structure is soM or offered for sale before or upon completion. If/ <br /> hire subcontractors, I will hin~ only subcontractors registered with <br /> the Constr~ction Conmactors Board. Ill change my mind and do <br /> hire a general contractor who is registered with the Construction <br /> Contractors Boanl~ I will immediateiy notify Marion County of tbe <br /> name of the contractor. <br /> <br />3. PLAN P~VIEW SECTION <br /> <br /> Marion County does not require a plan review. We will provide plan <br /> review service if you complete Section 5B and submit two (2) sets of <br /> I <br /> plans and specifications with this application. I <br /> I <br /> <br />MC 15-34 Rev 9/98 <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br /> FAX 588-7948 <br /> <br />Items Cost(each) Sum <br />-- x $110.00=$ 4 <br /> x $20.00=$__ <br />-- x $30.00=$__1 <br /> <br /> x $52.00=$__2 <br /> <br /> b) Ihe fee for branch clx~uit~ ~om ~e <br /> <br />E. MIseellaneous (Service or Feeder Not Included) <br /> Each pump or i~rlgation circle -- x $55,00 <br /> Each Sign or Outline Lighting -- x $55.00 <br /> Signal Circuit(s) or a Limited F~ergy <br /> <br />F. Each eddl#onal InSl~tlon <br /> <br /> above, Inr lml~ztion -- x $50.00 <br /> <br />IL Industrial Plant -- x $62.50&r <br /> Om/f,~oFamilygwd~gFee:Sq.F~et -- x $ .09=$__ <br /> nweltht~ Permit Labols {For Slagle Family Dwellings Only) <br /> OTItER, as required by the Building Official <br /> <br /> TOTAL <br /> <br />5. FEES Al. Enter total of fees from Sec. g4 <br /> <br /> A2, Add State Surcharge 605% x Al) <br /> <br />SUBTOTAL <br /> <br />B. Enter 30% of line Al fur Plan Review <br />C. Investigation Fee (if required) <br />D. Reinspection Fee ($50.00) <br />E. Additional Plan Review ($62.50/hr, <br /> minimum one-half hour) <br />F. Inspection for which no fee is specifically indicated, <br /> ($62.50/hr, minimum one hour) <br />G. Inspection Outside Normal Business Hours, <br /> ($62.50thr, minimum two hours) <br />N. Industrial Plant ($62.50/ar) <br /> <br /> TOTAL AMOUNT DUE <br /> <br /> <br />