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FOR ~ITY USE ONLY <br />R~eeived B~. ,r Date: <br />Zoning ~y: Ci~,: <br />R~il~ #: Amount: $ <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please compile ~ll S~tion$o I through $ <br /> <br />1. LOCATION OF INSTALLATION <br /> <br /> and <br /> <br /> PERMITS ARE NON- TRANSFERABLE AND EXPIRE IF FYORK <br /> I$ NOT STA~1ED WITHIN l gO DA Y$ OF I~SUANCE OR IF <br /> tVORK IS SUSPENDED FOR 180 DAYS, <br /> <br />2A. CONTRACTOR INFORMATION <br /> <br />Parkin Electric, Inc. 20250 S Molalta Ave. <br />Oregon City, OR 9704.5 503-657-4.956 fax: 5574059 <br />Contractors License #: 34-4C exp. 10-01-99 <br />Supervisor: 424'1.$ exp, 10-01-01 <br />Contractors Board Reg#: 35i51 exp, 10-12-00 <br />Metro# 2416 exp 11-01-99 <br /> <br />structure is sold or offered for sale before or upon completion. Ill <br />Contractors Board, I will immediately notiJ~ Marion CounO, of the <br /> <br />3, PLAN REV1EW SECTION <br /> <br />Marion Count'/do~ not t~quir~ a plan review. We will provide <br />plan review service ifyeJ complete S~;aion 5B and submit two (2) <br />sets of plans and specifications with this application. <br /> <br />~1~ MARION COUNTY BUILDING I~$PECTtON <br /> 3150 L~3150 ~r Dr. NE - Su~ C <br /> <br /> ~ Residential Per Unit, ~ice Included <br /> [t~ C~ (~ch) Sum <br /> 1000 St. Ft. or I~ x $110.00 =$ 4 <br /> ~ch Additio~1500 Sq. Ft. or ~ni~ ~¢r~f x $ 20.00 = $ <br /> Limit~ Enet~ x $ 30,00 = $ I <br /> <br /> M~ular Dwelling Semi~ or F~er x $ 52.~ = $ <br /> <br /> B. ~ices or Feeden ~oes not include branch Circuit, ~e ~cfioa D) <br /> <br /> 200am~t~ x $65.~ = $ 2 <br /> 201am~to4~ x $80.00 = $ .2 <br /> <br /> 601 am~to I000 am~ x $170.~ = $ 2 <br /> ~ l~0 am~ at vol~ x $390.~ = S 2 <br /> K~ Only x $ 5~0~ ~ <br /> C T~rl~ ~iee~eede~a - <br /> Installation, Alterations, or Relocation <br /> 200 am~ or 1~ x $ 4~.00 = $ .2 <br /> 20I am~to400 am~ ~ x $55.~ = <br /> 401 am~to600 a~ x $110.00= $ 2 <br /> <br /> D. Branch CircuiB <br /> New, Alteration, or gxtenaiou Per Panel <br /> <br /> ~f$~i~orF~erF~.~BrCir ~ x $ 3.00 = $ <br /> The f~ f~ b~ch c~ui~ ~out the <br /> <br /> Fi~ B~n~ Cffcuit I x $ 50.00 = <br /> ~¢h ~itio~l B~ch Circuit x $ 3.~ = <br /> Iseellaaeou~ (~lee or Feeder Not <br /> <br /> Si~ or Outl~e Li~t~g x $ 5~.00 = $ 2 <br /> I C~cuit(s) or a L~t~ En~r~ <br /> temtion, or E~i~ x $ 55.00 = $ ~2 <br /> <br /> Pack of 10 la~ls ~ $10.00 tach ~ x $100.~= $ <br /> <br />OTItER, as required by the Building Official <br /> TOTAL <br /> <br />5. FEES <br />Al. Enter Total Fees fi'om Section//4 <br />A2 Add State Su~eh~ge (.05% x Al) <br /> <br /> $ <br />SUBTOTAL: <br /> <br /> $ <br /> <br />B. Enter30%ofli~eAl for Plan Review $ <br />C. Investigation Fee, if required $ __ <br />D. Reinspection Fee ($50.00) $ __ <br />E. Additional Plan Review (62.50/in', <br />minimum one-half hour) $ __ <br />F. Inspection for which no fee is specifically indicated, <br />($62.50/b.r, minimum one hour) $ __ <br />G. Inspection Outside Normal Business Hou~ <br />$62.50/hr, minimum two hours) $ -- <br />lq. Industrial Plant ($62.50/hour) <br /> TOTAL AMOUNT DUE <br /> <br />MC 15-34 Rev 9198 <br /> <br /> <br />