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DATE: <br />OFFICE: <br />UGB: <br />CONST: <br />OCC: <br /> <br />Marion County Building Inspection <br />555 Court St. N.E., Room 2260, PO Box 14500 Salem, Oregon 97309-5036 <br />Office Hours: 8:00-4:30 Phone: (503)588-5147 Inspection Line: (503)373-4427 <br /> <br />MC <br /> <br />ELECTRICAL PERMIT <br /> <br />TYPE: ACOM ACTIVITY NO: <br />USE: C STATUS: <br />MAP: ISSUED: <br />ZONE: UT TO EXPIRE: <br />SITE: <br /> <br />99-05457 <br />EXPIRED <br />07/08/1999 <br />01/05/2000 <br /> <br />WORK DESC: <br /> <br />SITE ADDRESS: <br />PARCEL: <br /> <br />APPLICANT: <br /> ADDRESS: <br /> <br /> PHONE: <br /> <br />PARCEL OWNER: <br /> ADDRESS: <br /> <br /> PHONE: <br /> <br />CONTP~ACTOR: <br /> PHONE: <br /> <br />ELECTRICIAN: <br /> PHONE: <br /> <br />SUPV ELEC: <br />PHONE: <br /> <br />LABELS: <br /> <br />2/CIR FOR LIGHTING AT INTERMEDIATE SCHOOL <br /> <br />20237 NE GRIM RD AR <br />041W22B 01500 <br /> <br />RJ ROUSE ELECTRIC INC <br />16285 SW 85TH AVE #407 <br />TIGARD, OR 97224-5555 <br />639-5996 <br /> <br />NORTH MARION SCHOOL DIST NO 15 <br /> <br />RJ ROUSE ELECTRIC INC <br />639-5996 FAX: <br /> <br />R J ROUSE ELECTRIC INC <br />639-5996 <br /> <br />KERN THOMAS E <br /> <br />?? <br /> <br />OCCE: 0090454 <br />LICENSE: 34-359C <br />LICENSE: 661S <br /> <br />Units <br /> <br />Description Fee <br /> <br />Wiring Eased on sq ft $0.00 <br />Limited Energy $0.00 <br />PLANF SVC/Feed $0.00 <br />Service/Feed 200 amp $0.00 <br />Service/Feed 201-400 amp $0.00 <br />Service/Feed 401-600 amp $0.00 <br />Service/Feed 601-1000 $0.00 <br />S/P 1001 amps/volts & up $0.00 <br />Reconnect Only $0.00 <br />Temp s/f 200 amps $0.00 <br />Temp s/f 201-400 amps $0.00 <br />Temp s/f 401-600 amps $0.00 <br />Temp s/f 601-1000 amps $0.00 <br />Temp s/f 100 amp/volt up $0.00 <br />Branch Circuits $53.00 <br />Pump or Irrig Circle $0.00 <br />Sign or Outline Lights $0.00 <br />0 Additional Circuits ?? <br /> <br />Units Description <br /> Signal Circuits/LEP's <br /> Additional Inspection Hfs <br /> Overtime Inspection Hrs <br /> Reinspection Fee <br /> Label Fee <br /> Master Permit <br /> Plan Review <br /> Additional Plan Review <br /> Investigation Fee <br /> Other Fee <br /> Misc/Copy Fee <br /> State Surcharges <br /> Refund <br /> <br />Fee <br /> $0.00 <br /> $0.00 <br /> $0.00 <br /> $0,00 <br />?? <br /> $0.00 <br /> $0.00 <br /> $0.00 <br /> $0.00 <br /> $0.00 <br />?? <br /> $3.71 <br /> $0.00 <br /> <br />Total Fees: $56.71 <br />Total Payments: $56.71 <br />Balance Due: $0.00 <br /> <br />PERMIT IS NON-TP~NSFERABLE AND EXPIRES 180 DAYS FROM ISSUE DATE IF WORK HAS NOT COMMENCED, OR IF CONSTRUCTION <br />CEASES FOR A PERIOD OF 188 DAYS, OR IF WORK FAILS TO MEET ALL REQUIREMENTS OF STATE LAWS AND MARION COUNTY <br />ORDINANCES. UPON WRITTEN REQUEST, ONE SIX MONTH EXTENSION MAY BE GRANTED. <br /> <br />[ ] I am the SUPERVISING ELECTRICIAN. <br />[ ] I am the PROPERTY OWNER and own, reside in, or will reside in the completed structure and will be my own <br />general contractor. I understand that I must register as a construction contractor if the structure is sold or <br />offered for sale before or upon completion. If I hire subcontractors, I will hire only subcontractors registered <br />with the Construction Contractors Board. If I change my mind and do hire a general contractor who is registered <br />with the Construction Contractors Board, I will im/nediately notify Marion County of the name of the contractor. <br /> <br />SIGNATURE: X <br /> <br /> <br />