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Marion County Building Inspection <br /> 555 Coud St. N.E., Room 226Q PO Box 14500 Salem, Oregon 97309-5036 <br /> Office Hours: 8:00-4:30 Phone: (503)588-5147 Inspectioo Line: (503)373-4427 <br /> Check your Permit Status On Line at: http://publicworks.co.marion.ocus/building/ <br /> ELECTRICAL PERMIT <br /> DATE: 01-03-2008 TYPE: ELEC PERMIT N0: OB-00021 <br /> <br /> OFFICE: MC USE: R STATUS: ISSOED <br /> CONST: MAP: 60 ISSOED: O1/03/2008 <br /> OCQ SITE: G TO EXPIRE: 07/03/2008 <br /> ZONE: EFO <br /> WORK DESC: LE FOR DATA, PHONE~ & CATV <br /> SITE ADDRESS: 11022 RAINWATER LN SE AM <br /> PARCEL: 091WP 00300 <br /> APPLICANT: STAYTON COOP TELEPHONE <br /> ADDAESS: PO BOX 977 <br /> STAYTON~ OR 97383 <br /> PHONE: 503-769-2121 <br /> PARCEL OWNER: FERY,LOYD F <br /> AODRESS: 11022 RAINWATER LN SE <br /> AOMSVILLE OR 97325 <br /> PHONE: <br /> CONTRACTOR: STAYTON COOP TELEPHONE OCCB: 0133167 <br /> PHONE: 503-769-2121 FAX: <br /> ELECTRICIAN: KOHLS DAVID L LICENSE: 907JLE <br /> PHONE: <br /> SOPV ELEC: LICENSE: <br /> PHONE: <br /> SPECIAL ELEC: LICENSE: <br /> PHONE: <br /> [lnits Description Fee Units Description Fee <br /> Wixing Based on sq ft $0.00 Signal Circuits/LEP's 50.00 <br /> 1 Limited Energy $65.00 <br /> MANF SVC/Feed $0.00 <br /> Service/Feed 200 amp 50.0~ <br /> , Service/Feed 201-400 amp 50.00 Label Fee 50.00 <br /> Service/Feed 901-600 amp $0.00 Master Permit 50.00 <br /> Service/Feed 601-1000 $0.00 Plan Review $0.00 <br /> 5/F 1001 amps/volts 5 up 50.00 Additional Plan Review 50.00 <br /> Reconnect Only 50.00 Investigation Fee $0.00 <br /> Temp s/f 200 amps 50.00 Other Fee 50.00 <br /> Temp s/f 201-900 amps 50.00 Misc/COpy Fee $0.00 <br /> Temp s/f 901-600 amps $0.00 State Surcharges 57.80 <br /> Temp s/f 601-1000 amps S0.00 Refund 50.00 <br /> Temp s/f 100 amp/volt up 50.00 <br /> Branch Circuits $0.00 <br /> Pump or Irrig Circle $0.00 Total Fees: $72.80 <br /> Sign or Outline Lights $0.00 Total Payments: $72.80 <br /> Additional CirCUits $0.00 BalanCe Due: $0.00 <br /> PERMIT IS NON-TRANSFERABLE AND EXPIRES 180 DAYS FROM ISSUE DATE IF WORK HAS NOT COMMENCED, OR IF CONSTRUCTION <br /> CEASES FOR A PERIOD OF 180 DAYS~ OR IF WORK FAILS TO MEET ALL REQ[IIREMENTS OF STATE LAWS AN~ MARION COUNTY <br /> ORDINANCES. OPON WRITTEN REQOEST~ ONE SIX MONTH EXTENffiON MAY BE GRANTED. <br /> [ ] I am [he SOPERVISING ELECTRICIAN. <br /> I am the PROPERTY OWNER and own, reside in, oi 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 wi11 hire only subcontractors registeretl <br /> with [he Construction Contractors Hoard. If I change my mind and do hire a general contractor who is registered <br /> with the Construction Contractors Hoard, I will immediately notify Marion County of the name of the contractor. <br /> SIGNATURE: X <br /> WARREN DJACKSON, MARION COUNTV BUILDMG OFPICIAL / BY PCOL9MAN <br /> CALL BEFORE YOU DIG._IT'S THE LA W. <br /> ATTENTION'.Oregonlawreyui~as}roumCOllowmlesadopledbylheOreyonUtilityNOliflcalionCe+nu.TFosemleeercsUforthbyOreyonAdminis¢eliveRUles-Yo ayobtainwpiesof~herulesbycallinglhcunlu. <br /> [Nme, The ~elephonc numbu 6r Ne Oregon U Wiiy NoliGca~ion Cen~u is 1~00.332R3G6). <br /> <br />