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FOR CITY USE ONLY <br /> <br /> R~:~ipl #: ~: <br /> <br />I ELECT~CAL PE~ APPLICATION <br /> Pl~e ~l~e ~ S~ons, I through 5 <br /> <br />1. LOCATION OF ~STAL~TION <br /> <br /> WO~ IS S~PENDED ~R 180 DA Y~ <br /> <br />~ CON~OR ~FO~TION <br /> <br /> lB. FOR O~ER ~TION' ' <br /> <br /> ~ ~er: ~lease prin0 <br /> <br /> Ci~: S~te: Zip: <br /> <br /> completed $~ucture a~ wiO be my own general con.actor, I <br /> <br /> s~cture ~s <br /> hlre subcontractors, I will hire on~ subcon~actors registered with the <br /> Cons~uction Conwactors Board. [fl change my mind and do hire a <br /> general con.actor who ~s registered with the Cons~uction <br /> Con.actors Board, I will immediately not~ Marion Coun~ of the <br /> name of the con.actor: <br /> <br />Owner's Signalu m: <br /> <br />3. pLAN REV[gW SECTION <br /> <br />Marion County does not requi~e a plan reviaw. We will provide <br />plan reviev~ servic~ if you complete Section 5B and submit two (2) <br />s6is of pla0a a~d sgecifications ';,ida this application. <br /> <br /> MARION COUNTY BUILDING INSPECTION <br /> 3150 Lan3150 Lancoster Dr. NE - Suite C <br /> Salem, Oregon 97305 <br />8:00 am- 4:30 pm 24 hr, Inspcctiol~ Line 3734427 FAX 588-7948 <br /> <br /> Numb~ of lnsp~..lions per permit allowot-- <br /> A. Residenilal Per Unit, Service Included <br /> Items Cost (~ach) Sum <br /> 1000 St. Ft. or less x $110.00--$ 4 <br /> Eae3AdditionalS00$q. Ft. orpo~ioathe~of -- x $20.00 KS <br /> Limil~d En~gy x $ 30.00 = $ , l <br /> Ea Manufisctu~d Hcag or <br /> Modular Dv~ling Serviceor Feeder x $52.00 -- $ / <br /> B. Servleez or Feeders (Does not ira:lade branch Circnils. ~ee Section D) <br /> lnstatiation, Alteration, or Relocation fl <br /> 200 an~ or .teas p<. x $65.00 = $ <br /> 201ampsto400amps x $80.00 = $ · 2 <br /> .401 ariosto600 an~ x $130.00= $ 2 <br /> 601 amp~ lo 1000 amps x $170.00= $ 2 <br /> Over 1000 amps or voils x $390.00-- $ 2 <br /> Reconnect Only x $ 55.00= $ 2 <br /> C. Temporary Service~/Feedcrs <br /> Iaatalintiou, Alterations, or Rdoeatiou <br /> 200 an~ of le~ x $ 45.00 = $ 2 <br /> 201 amps Io400 amps x $ $5,00 -- $ 2 <br /> 401 amps to 600 amps x $110.00 = $ 2 <br /> Ova 600 amps or 1000 volta, ~ec "B" above <br /> <br /> New, Alteration, or Extension Per Panel <br /> .) ~S-~ fm fcrbca~h~'ircuitswlihti~l~urcha, lo 3.00 = $76 <br /> of Service or Feeder F~. Ea Br Cir x $ ... <br /> b) The f~ for Immch circuits withom the <br /> ou re. lu~e of Servi~ or Feeder F~e: <br /> First BranchCir~uit x $50.00 = $ <br /> EachAdditienalBranchCircuit x $ 3.00 = $ <br /> E. Miscellaneous (Servlee or Feeder Not Included) <br /> Each lan'ap o~ i.~6oncir~l~ x $55,00 -- S 2 <br /> Each Sign or Outline Lighting -- x $ 55.00 = $ 2 <br /> Signal Circuit(s) or a Limit~l En~gy Panel, <br /> Alteration, of Exten~n x S55.00= $ 2 <br /> F. Each Additional inspeetion, over the allowable <br /> 'tn any of the above, per inspection x $ 50.00 = $ <br /> G. Minor Installation LabeLs <br /> Pack of t0 tabcta ~ $10.00 each x $100.00= $ <br /> (Sold only to Elec~cal Contractors) <br /> H. Induatrial Plant x $62.50 / hr = $ <br /> OnetTwo Family Dwelling Fee: Sq. Feet x $ .09 = <br /> <br /> Dwelling Permit LabeLs (For Sing.te Family Dv,~Rings Only) <br /> OTHER, a~ required by the Building OW~ial $ -- <br /> TOTAL $ <br /> <br /> 5. FEES <br /> Al. EntcrTotal Fees from Sex'finn#4 <br /> $ <br /> <br />B, Entcr30%oflineA1 for Plan Review $ <br />C. Investigation Fee, if required $ __ <br />D. R¢inspectien 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 />$62.50far, minimum two hours) $ __ <br />H. Industrial Plant ($62.50/hour) <br /> TOTAL AMOUNT DUE $171,0 ° <br /> <br />MC 15-34 Rev 9/98 <br /> <br /> <br />