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MARION:~0UNTY <br />BUILDING INSPECTION <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> ~at¢~ 1~1~. NO. 22S <br /> 2~0 High gt~t NE <br /> Salem~ Oregon 97301 <br /> <br /> . ' <br /> 0 ~M'., , :" <br /> <br /> ELECTRICAL PERMIT APPLICATION <br /> <br /> Phone: Mailing,_Address: t <br /> Site NO,: r Or'ess Street: <br /> '1' ' <br /> ) Phone: <br /> <br />Electrical Contractor's No,: <br /> <br />Electrisian~ No.;.~",,~"-,,~ ~ Useof <br /> Building: <br /> <br /> Home Builder's Registration No.; <br /> <br />Residential [] New [] Addition ~ Occupancy <br />Commen::ial [] Alteration [] Relocation [~ Change [] <br /> <br />No. RESIDENTIAL <br />...... Residencewiringlessthanl000sq, ft ................................. @$ 50.00 __ <br />__ Residencewidaglessthan2000tiq, ft ................................. @$ 75,00 <br />_~ g. estdensewiringover2000sq, ft .................................... ~'~$ 105.00 __ <br />__ EleCtric heat installation in existing residence ........................... @ $ 30,00 <br /> SERVICES <br />Temporary ConstruCtion Service ..................................... @ $ 30.00 <br />,__ Service change only Irt art existing residence ........................... @ $ 30.00 <br />Commemlal or Industrial: <br />...... Service not over 100 amperes ....................................... @$ 45,00 <br />__ Service over 100 amperes but not more than 200 amperes ................. @ $ 70.00 __ <br />__ Service over 200 amperes bat not more than 400 amperes ................. @ $ 100.00 <br />__ Servlceover400amperesbutnotmorethan600amperes ................. @ $ 150,00 <br />~__ Servlceover600amperes ......................................... @$ 200.00 <br /> <br />~ Servlceever600volts ............................................. @ $ 450,00 <br /> COMMERCIAL AND INDUSClI'RIAL FEEDERS <br /> Installation of Alterations or Reloeatloll of Distribution Feeders: <br />.... Not more than 100 amperes ........................................ @~ $ 25,00 <br />__ Over 100 amgeres but r,x3t more than 200 smpera~, ....................... @ $ 40,00 <br />__ Over200amperesbutnotmomthan400ampems ....................... @$ 70.00 <br />__ Over400amperes ............................................... @$ 85.00 <br />__, Feederover600volts ............................................. @ $ 120.00 <br /> MISCELLANEOUS <br />/ A. Eachtrailerormobilehomespace(Serviceequipmenb .................. @$ 25,00 <br />__ B, Eachsupplyformobilehome(Connection) ........................... C~$ 25,00 <br />____ C. Each irrigation punlp (Attach a map showing location) ..................... @ $ 30.00 <br />__ D. Each electric sign or outline lighting ................................ @ $ 30.00 <br />~__ E. Each swimming pool (bOnding) ................................... @ $ 30.00 <br /> BRANCH CIRCUITS <br />__ One new si~:ult; alteration or extension ............................... @ $ ;Z0.00 <br /> <br /> ___ Two or mere new circuits; alterations or extensions ....................... @ $ 30.00 ~ <br /> Other (as per NEC and Building Offlclal) ......................................... <br /> .__ On-SiteTechnlcalReview(applydirectlyatMarionCountyonJy) ...................... <br /> ___ Industrial Plant InSpection (apply direcgy et Marlon County o¢1~¥) ...................... <br /> <br /> agree tO make the eleclrlcal i I~ s~ti~:t~a c ~d i r i g to t he.~.~ mia.~j~d Speclticlati0n$. the laWS Of the State Of Orego, a~d the O~i,a~ces 0f Marlo, C0un~. <br /> 0 <br />SiGNATUREOFAPPLI~NT:~ ~ ¢0~ ~ : <br />~ HOMEOWNERS - I hereby ce~i~ that I am tbs owner of the pro~ de~rib~ above, at which location I p~pose to m~ an electrical installation for <br /> my ow~ use and thi~ prope~ is not being constructed ~r sale, lea~e or rant. <br /> <br />SIGNATU RE OF APPLICANT: <br /> <br /> <br />