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FOR O~ICE USE ONLY <br />Received by:, <br />Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> 220 High Slreet NE <br /> Salem, Oregon 97301 <br /> <br /> l~ao~ ~88-5147 $:00 ~a - 4.30gm <br /> FAX: 5a~-7~ $1T~ #: <br /> <br />I ELECTRICAL PERMIT A.PPLICATION <br />I ,,,,,,please complete all Sections, I thm. u..gh 5 <br /> <br /> PERMITS ARB NON-TRAW~LE AND NON-R]~PI.,~DABI~ AND <br /> RXPiRE IF WORK I~ NOT STARTI~ ~ lg0 DAY~ oFI$~'UAI~CE <br />,, ,OR ~P WORK IS SUSPI~IDI~ I~R 180 DAYS. <br /> 2~ CONTRACTOR INSTALLATION ONLY <br /> <br />2B. FOR OWNI~R INSTALLATIONS <br /> <br />Mailing Add,us <br /> <br />~ REVIEW SECTION <br /> <br /> We will provide plan review scrvic~ if you ~om~plcm Sect/on <br /> 5B and submit two (2) zet~ of plan~ and specifications with <br /> this application. <br /> <br /> This optional plan rcvicw program does not suspead the <br /> required submission of lighting power calc,n~ons, plans, <br /> and specifmatloas when requh~l by the Oregon Stmcturnl <br /> Specialty Co~, C~al~ 53. <br /> <br />MC 15-34 HIgl <br /> <br />Permit No. <br /> <br />Date: <br /> <br /> Issued by: .............. <br /> <br />4, FEE $¢:~ ~OULE (Compt~ md en~r m~d ~ Al ~w) <br /> <br />~~ $15,~ <br /> I~h~ ~m~ns ~ Rd~ <br /> <br />S100.00 <br />$1.30,00 <br />$ ,,',,',,',,',,',,'~ 0.00 <br />$40.00 <br /> <br /> 2 <br />$80,00 __ 2 <br /> <br />$2,00 <br /> <br />$40D0 -- 2 <br /> <br /> <br />