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IFOR ~ VALIDATION[ <br /> <br />BUILDING INSPECi1ON DMSION <br />3150 L~nca~tea Dr. NE - Sui~ C <br /> Salem, Or~gon 97305-139g <br /> <br /> 24 HR Inspection Line 373-4427 <br />Office: phone .~-S147 8:00am - 4:30pm <br />FAX 588- 7948 <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete all Sections, I through 5 <br /> <br />1, LOCATION OF INSTALLATION <br /> <br />I,,''oNE I I I-I vi I-.1 1 17 <br />I c~oss s~~ ~ ~ ~ ~ .... <br /> <br /> ~ ~ NON-~S~LE ~ E~ · WO~ IS NOT <br /> ST~f~ ~ l~ DAYS OF ISSU~ OR IF <br /> WO~ IS SU$~ FOR 180 DAYS. <br /> <br />CONTRACTOR INSTALLATION ONLY <br /> <br />El~ic~l Cona.actor Judson' s INc. <br />MaiJinsAddmSs P.O. Box 12669 ci~Salem <br /> <br />~. 5 0 3 -- 3 6 3 [- 4 ] 4 1 <br />F~ 5 0 3 -- 3 9 9 -- 8 7 6 0 <br /> <br />C~n L~ No. 2 4 -- 1 8 C <br />~n~No. '3 4 6 0 4 <br />S~i~L~ 1 3 6 9 S <br /> <br />2B. FOR OWNER INSTAI,L&TIONS <br /> <br />~. PLAN REVIEW SECTION <br /> <br /> Marion County does not require a plan review. <br />We will provide plan review service if you complete <br />Section SB and submit two (2) sets of plans and <br />[,?~cifications with this application. <br /> <br />PERMIT NO: ~ <br />D=: <br /> <br />Limit~ Emr~ <br /> <br />2 <br />2 <br /> <br />S35.00 <br /> <br />$40,00 2 <br />$40.~0 2 <br /> <br />~40.00 2 <br /> <br />$~$.00 <br /> <br />$50.00 <br /> <br />sq, e. x S.068 <br /> <br />FEES <br /> <br />C. lavestiption Fe~ (if requital) <br /> <br />Receipt No. -- <br /> <br />Sutm~l <br /> <br />MC 15-$4 7/97 <br /> <br /> <br />