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MARION COUNTY BUILDING INSPECTION <br />Senator Bldg. NO, 228 <br />220 High Street NE <br /> Salem, Oregon 97301 <br /> <br /> Phone 588-5147 <br /> Code-A-Phone 4:30 RM. - 8:00 A.M. <br /> <br />ELECTRICAL PERMIT APPLICATION <br /> <br /> Phenol ..... Mailing Address: <br /> Phone: Address: <br />~ctriclen: Phone: Address: <br /> <br />~ctor~ No,; Home Buildeds Registration NO.: <br /> I Useof j~ ']~Resldential r'q ~J New ~ "Addition [] ...... Occupancy <br /> <br /> Job Address: <br /> <br />..... Elect rio,.,~l Firm; <br /> <br /> Supervising <br /> <br /> Electrical Contract, <br /> <br />Supervising ~ <br />Electrician~ NO,; Building: <br /> <br />Alteration [] Relocation [] Change [] <br /> <br /> NO, RESIDENTIAL <br />____ Residence wiring less then 1000 sq. ft ................................. (~ $ 50,00 <br />..... Residence wiring legs than 2000 sq, ft ................................. ~4) $ 75,00 <br />__ Residence wiring over 2000 sq. f~ .................................... @ $ 105.00 <br />__ Electric heat installation in existing residence ........................... @ $ 30.00 <br /> SERVICES <br />__ Temporary Construstion Service ..................................... @ $ 30,00 <br />__ Servicechangeonlyinanexlstingresidence ........................... @$ 30.00 <br /> Commemlel or Industrial: <br />__ Service not over 100 amperes ....................................... @ $ 45,00 <br />__ Service over 100 amperes but not more than 200 amperes ................. @ $ 70.00 <br />I , Serviceover200amperesPutnotmorethan400emperes ................. @$ 100.00 <br />__ Serviceover400amperesbutnotmorethanC00amperes ................. @$ 150.00 <br />__ ServiceoverC00emperes ......................................... @$ 200.00 <br />__ ServiceoverC00volts ............................................. @ $ 450,00 <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br /> Installation of Alterations or Relocation of Distribution Feeders: <br />__ Not morethan 100amperes ........................................ @ $ 25.00 <br />.... Over 100 amperes but not more than 200 amperes ....................... (c~ $ 40.00 <br />__ Over 200 amperes but not more than 400 amperes ....................... @ $ 70,80 <br />__ Over400amperes ............................................... @$ 8.5.00 <br />__ Feederover60Ovolts ............................................. @ $ 130.00 <br /> MISCELLANEOUS <br />__ A, Eachtrailerormobilehomespace(setvlceequipmer~t) .................. @$ 25.00 <br />__ B, Each supply for mobile home (Connection) ........................... @ $ ')5.00 <br />........ C. Each Irrigation pump (Attach ~ m~p showing location) ..................... @ $ 30.00 <br />__ B, Each electric sign or outline lighting ................................ @ $ 30.00 <br /> E, Each swimming pool(bonding) ................................... @ $ 30.00 <br /> BRANCH CIRCUITS <br />__ Onenewcircuit;alterationorextension ............................... @$ 20,00 <br /> Two or more new cireuits; alterations or extensions ....................... @$ 80.00 <br />__ Other (as per NEC and Building Official} ......................................... <br />.......... On-Sire Technical Review (apply directly et Medon County only) ...................... <br />__ indumrial Plant Inspection (apply directly at Marion County only) ...................... <br />.... Reinspection Fee ................................................ C~~ $ 20.00 <br /> FEE <br /> STATE SURCHARGE <br />Please return COMPLETE APPLICATION PLAN REVIEW FEE <br />with the indicated fee. ~ <br /> FLEET <br /> SURCHARGE <br /> TOTAL <br /> <br /> ~ / / ~ (SupervlslnsElectrlclar~) <br />HOMEOWNERS - I hereby certify that I am the owner of the property described above, at which Jocation I propose to make an eJectrical installation for <br />mY own uce and this ProPS//7, is~Lnot b,~d for sel,, leese or re~t- <br /> <br /> <br />