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FOR CITY VAILmATIONI <br /> I <br />Date: <br /> <br /> MARION COUNTY <br />:BUILDING INSPECTION DIVISION <br />3150 LANCASTER DR NE - SUITE C <br />SALEM OREGON 97305-1398 <br /> <br />[4080 · m - 4:30pm <br /> <br />ELECTRICAL PERMfr,,APPLICATION <br />Pleas~ compl~to ~11 .qoctions, I through 5 <br /> <br />MARION COU <br />BUILDIN6 INSPI <br /> <br /> 1. LOCATION OF INETALLATION <br /> <br />Job Address <br /> <br />Jo~ l:~scripQon: ALAR~ <br /> <br />I PERMITS <br /> A R~ NON- ~'I~ANSFERABL~ AND ~IR]E I!; WOi~K L~ NOT <br /> <br />STARTED wrrHIN 180 DAYS OF ISSUANC~ OR <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />2A. CONTRACTORINSTAIJ.4TiON ONLY <br />[~ecuicil Contractor RR Tl,,~.q HOME ,qECITRTT~ <br /> <br />m°n~ (503) 641~0574 <br /> <br /> No. 34166cle <br />Conu'ac~r:s l~ru 1~¢ No. 04'4421 <br />.S. ig na lmm of Sup~L~L~g ElectrJc[~ <br /> <br /> FOR O~ ~AT.T.~ONS <br /> <br />)641-09~ <br /> <br />(~ty/SlateJZip <br /> <br />- Owners Signeu=~ <br /> <br /> 3: pLAN~:sI]CTION <br />I Mad°n"-C°- unt~:t!oesu°t~ aplan review. <br />{ We WilFi~rovide'pl~. review s~ic~ ifydu'~ompzet¢ <br />I' seCfiO~.SB .and s. ub~t two i2) Seis of plani and <br /> <br />MC 15-34 1/96 -- <br /> <br />PERMIT NO: ~ <br />Dale: <br /> <br />Issued by:, <br /> <br /> <br />