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MARION COUNTY <br />",BUILD NG INSPECTION DIVIS[ON <br />3150 LANCASTER DR NE - SUITE C <br /> <br />FOR CITY VAI.mATiONI <br />}~.~i,~.d by: <br />Date: . [ <br /> <br />SALEM OREGON 97305-1398 <br /> <br /> Otlic¢:'?h0n~.~.~ 4~Opm issued by: <br />ELECTRICAL PERMITAPPLIOATION ~.~ <br />P/ease comploto ~11 S~tions, 1thrOugh 5 APFH1 , .. <br /> '4. ~1~1~ ~C H 14 ~l[JI.j~ (Compile and ea[~r Iot~l in A 1 below) <br /> <br />2A. C O/,,*I'R. ACTOR-Zlq-~,TAT j. A.TiON ONLY <br /> <br />?lec~k~lContractor RRTNI~,q ROI, fl*. SECIIRI~ <br /> <br />zd~m'805~ S.~; CSrrus Dr. <br />Fho~ (503) 641-0574 <br /> <br />~~ No. 34166cle <br /> <br /> - n ~,h 1~503~ 641-0' <br /> FOR O~ ~AI;L~ONS <br /> <br /> .Mailin~ Addr~ <br /> <br />~y/StateFZip <br /> <br />3. PI-a~BI~:SIECTION <br /> <br />Mafi0~,m/t~';dO~:nb t!'r~luim a plan review, <br /> <br />~tiqa.:~l~ ,and..q. ub~ .mi.'( twO (2),sets. otplan~ and <br />s~eCific~tioiis'wtth/~g 'application. <br /> <br />MC 15-$4 1/96 <br /> <br />ZOO . <br /> <br />$35.00 <br />$ 2.00 <br /> <br /> <br />