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MARION COUNTY <br />!BUILDING INSPECTION DIVISION <br />3150 LANCASTER DR NE - SUITE C <br /> <br />FOR CITY VALmATIONI <br />R&~i*~a br., <br />Datc: . <br /> <br />SALEM OREGON 97305-.4-~'8~ <br /> <br />ELECTRICAL PERMITAPPLICATION I~RIOR COt <br />Please complete.all ,.~ections, I tfirougbl~l~OlNG <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />/ob Dcsctlptlon: <br /> <br />PE!~dlT~ ARE NON- ~'rP~AN. SFERA.BLF. A~ND EXPII~E IF WORK IS NOT j <br /> ~rART~) ~ 180 DAYS OF ISSUAN(~ OR tF <br /> 1 <br /> WORK IS SUSPENDED FOR Ii0 DAYS, <br /> <br />2A. CONTRACTOR'Ii~I~rALL&TION ONLY <br /> <br />2~. FOR o~N-m~ INSTbT.LA_TIONS <br /> <br />M~ Add~ [ Phdae <br />City/S tale,,'Z~p <br /> <br /> 3: PLAN ~:SECT~ON <br /> <br />we wil, l~Pmv~de, pl~ h~vie~ ~ ify6u C'omplete <br />S~O~i~B 'and~.ub~t two (2),seta of pla~ and <br />~/~ecificafions'with {bls aP~plicaiiOfi.: ' ' <br /> <br />MC 15-341.96 <br /> <br />PERUrr.O: ff_ - d,2 ?2.2-- <br /> <br />Date: '- ... <br /> <br /> Issued by: <br /> <br /> ~TI0# ........ -. <br /> <br /> "I~ ~. ~ 1~':- $s5.~ 4 <br /> ~ ad~ ~. fL <br /> ~f SlS.~ <br /> <br /> ~'~c~ or ~ ~-~ 2 <br /> .. ~or~ $~.~ 2 <br /> <br /> ~; ~t~a~ ~ E~e~oa P~ Pand <br /> <br /> " ~&~ ~.~c~lc ~.~ 2 <br /> <br />"~.. <br /> m'~. k:~' '--- <br /> <br />".' A~'D~[~ . sq fi xSO~= <br /> <br />AZ Add $~ s~,~-chat~ (.05 x Al) <br /> <br />~bto:al <br /> <br />t P. cvicw <br /> <br />· . P,.~ipt No. <br /> <br /> <br />