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Marion County Building Inspection 5155 Silverton Rd NE - PO Box 14500 - Salem, Oregon 97309 Phone: (503)588-5147 Inspection Line: (503)373-4427 Check your Permit Status On Line at: http://publicworks.co.marion.or.us/building/ ELECTRICAL PERMIT DATE: 05-23-2011 TYPE: ELEC PERMIT NO: 08-04154 OFFICE: WB USE: R STATUS: FINAL CONST: MAP: 13 ISSUED: 06/18/2008 OCC: SITE: UG TO EXPIRE: 04/02/2009 ZONE: N ________________________________________________________________________________________________________________ WORK DESC: 2145 SQ FT ELEC FOR NEW HOME, LIMITED ENERGY SITE ADDRESS: 1275 COOLEY RD WB PARCEL: 051W08DD06900 APPLICANT: PETERSEN,DAVID & ADDRESS: 2210 WEST MAIN ST #107-227 BATTLE GROUND WA 98604 PHONE: PARCEL OWNER: DML ELECTRIC ADDRESS: PHONE: CONTRACTOR: OCCB: PHONE: FAX: 541 923-3373 ELECTRICIAN: DML ELECTRIC LICENSE: 0161264 PHONE: 541-410-3577 SUPV ELEC: DML ELECTRIC LICENSE: 51055 PHONE: 541-410-3577 SPECIAL ELEC: LICENSE: PHONE: ____________________________________________________________________________________________________________ Units Description Fee Units Description Fee Wiring Based on sq ft $210.00 Signal Circuits/LEP's $0.00 1 Limited Energy $65.00 MANF SVC/Feed $0.00 Service/Feed 200 amp $0.00 Service/Feed 201-400 amp $0.00 Label Fee $0.00 Service/Feed 401-600 amp $0.00 Master Permit $0.00 Service/Feed 601-1000 $0.00 Plan Review $0.00 S/F 1001 amps/volts & up $0.00 Additional Plan Review $0.00 Reconnect Only $0.00 Investigation Fee $0.00 Temp s/f 200 amps $0.00 Other Fee $0.00 Temp s/f 201-400 amps $0.00 Misc/Copy Fee $0.00 Temp s/f 401-600 amps $0.00 State Surcharges $33.00 Temp s/f 601-1000 amps $0.00 Refund $0.00 Temp s/f 100 amp/volt up $0.00 Branch Circuits $0.00 Pump or Irrig Circle $0.00 Total Fees: $308.00 Sign or Outline Lights $0.00 Total Payments: $308.00 Additional Circuits $0.00 Balance Due: $0.00 _____________________________________________________________________________________________________________ PERMIT IS NON-TRANSFERABLE AND EXPIRES 180 DAYS FROM ISSUE DATE IF WORK HAS NOT COMMENCED, OR IF CONSTRUCTION CEASES FOR A PERIOD OF 180 DAYS, OR IF WORK FAILS TO MEET ALL REQUIREMENTS OF STATE LAWS AND MARION COUNTY ORDINANCES. UPON WRITTEN REQUEST, ONE SIX MONTH EXTENSION MAY BE GRANTED. _____________________________________________________________________________________________________________ [ ] I am the SUPERVISING ELECTRICIAN. [ ] I am the PROPERTY OWNER and own, reside in, or will reside in the completed structure and will be my own general contractor. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change my mind and do hire a general contractor who is registered with the Construction Contractors Board, I will immediately notify Marion County of the name of the contractor. SIGNATURE: X_________________________________________________ _____________________________________________________________________________________________________________________________ WARREN D. JACKSON, MARION COUNTY BUILDING OFFICIAL / BY SSPRAUER _____________________________________________________________________________________________________________________________ CALL BEFORE YOU DIG...IT'S THE LAW. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth by Oregon Administrative Rules. You may obtain copies of the rules by calling the center. (Note: The telephone number for the Oregon Utility Notification Center is 1-800-332-2344).