Laserfiche WebLink
MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> 285 Church St NE · Room 132 PERMIT NO: <br />~ CITY VALIDATION] Salem, OR 97301 <br />I Received by: / <br />I Date: ~ 1 <br /> <br /> ELECTRICAL PERMIT APPLICATION - <br /> <br /> Number o f lnsp~etiom p~ permit allow~l <br /> <br /> 1. LOCATION OF I~8TALLATION [~lJ~Bt0~ CDU~'~ A. Re~ddential Per Unit Iterm Coat (each) Sum I <br /> <br />('N~c Po.W-, <br /> <br /> PERMITS ARE NON-TRANSFERABLE AND EXPIRE IF WORK IS NOT <br /> STATED WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPFaNDED FOR 180 DAYS. <br />2A. CONTRACTOR INSTALLATION ONLY ~0''C~ <br /> <br />MailingAddr~s ¢O, ~O~( {055 <br /> <br />;TII <br /> <br /> City/State/Zip <br /> <br /> Owner's Signature: <br /> <br /> :3. PLAN RBVItlW SRCTION <br /> <br />IMarion County does not require a plan review. <br /> We will provide plan review service if you complete <br /> Section 5B and submit two (2) sets of plans and <br />specifications with this application. <br />MC 15-J4 12/94 <br /> <br />I~O0 sq. 11. or less $85.00 4 <br /> <br /> Each branch circuit ~ $2.00 ~0~ <br /> Each pump or irrigation circle :M0.00 -- 2 <br /> <br />Al. Enter total of fees from Sec.//4 $ <br /> <br /> TOTAL AMOIJNT DUE $. <br /> <br /> <br />