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IFOR CITY VAT.1T)ATION[ <br /> <br /> MARION COUNTY <br />!BUILDING INSPECTION DIVISION <br />3150 LANCASTER DR NE - SUITE C <br />SALEM OREGON 97305-1398 <br /> <br /> ELECTRICAL PERMIT APPLICATION <br />· Please completeall Sections, I through <br /> <br />I. LOCATION Otr II~ISTALLATION <br /> <br />PERMIT NO'~., <br /> <br />Date: <br /> <br />Issued by: <br /> <br />$15.00 <br /> <br /> Limlted F. ae[~7: ;:': .'. , $20,00 <br /> . 'F. fi~liMii~faetui~ Home or ModaJ.r $40.00 <br /> <br />,b D=cri~o.: . .,, ' ' I ,.' ~,,~tle~.tkm o~ <br /> · ' !' :'~.m~,or ~', <br /> <br /> - .-, li"~ '.;60I '~i~p ~:10oo ~ml~ $130.00 <br /> <br />, ~ ~ W . : . :,::..O~/~r.'i000~orvelc~ <br />' ST^RTEDV'/ITBIHIS0DAY$OFISSU'ad'iC~ORIF I l: '" :' .. <br /> wo~.[ Is sus~w~ FO~ [so ~aYS. / C. <br /> <br />2A. CONTP ACTOR'I T/ I,I- TION ONLY <br /> <br />$40.00 <br /> <br />$35.00 <br /> <br />2 <br />2 <br />2 <br />2 <br />2 <br /> <br /> ..S~fioi~!5~ ~nd~sUbmii ~o i2)setS'of plan/and <br />I spec~ficstmns w~th fliisapphca~on. <br /> <br />2 <br />2 <br /> <br />2 <br />2 <br /> <br />2 <br /> <br /> <br />