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JRN-27-98 TUE 11:46 ~M LINNCO ELECTRIC CO <br /> <br />P, 01/01 <br /> <br />FOR CITY,VALIDATION [ <br /> <br />BUILDING 1NSFECTION DIVISION <br />3150 Lancaster Dr, NE - 5u[[c C <br /> Salem, Oregon 99305-139g <br /> <br />Date: <br /> <br />Issued by: <br /> <br />ELECTRICAL PERMIT APPLICATION <br />P/ease complete all Sections, 1 through 5 <br /> <br />1. LOCATION OF iNSTALLATION <br /> <br /> JOB ADDRESS -~C,G i~.~x ~gi~ <br />jctTv' ~ion ~ty ~l o~ <br /> PRO~EKTY O~EE O~ <br /> <br /> P~O~CT D~C~P13ON ~aff~c si~l <br /> <br /> PERMITS ARE NON.TRANSFER.ABLE AND EX~IRE IF WORX IS NOT <br /> STARTED WITHIN 1 ~ DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR {8o DAYS, <br /> <br />2A. CO~CTO" INST~LATION ONLY ¢ / 7 ~ ~ <br /> <br />Electrlca[ Contrac[or g c I~o Electric <br />M~ilin~ Add,¢~ P 0 ~X ~25 Ciu Al~y <br /> <br />~l~o,~ 5 4 1 ~ 9 2 6 - 4 2 6 6 <br />FAX 5 4 1 ~ 9 2 6 ~ 4 2 6 8 <br /> <br />ConU~ctoeBoard Re8 No. 4 9 7 3 7 <br />$up~i/orLi~nso 3 2 5' 7 S <br /> <br />2B. FOR OWNER INSTALLATIONS <br />?roper~y Owl~¢r (pl~ aa-e prflll) <br /> <br />Mailing Address <br /> t', State, Zip <br /> <br />4. FEE SCHEDULE iComplctc~d en~r Io~[ in Al below) <br /> <br />2au ;rain ur le~s 1 550,00 50. ~ 2 <br />~a:h br~h ek~':it 2 SI.CO ~ .00 <br /> <br />5, FEES <br /> <br />2 7 199 <br /> <br />$ <br />s <br /> <br />MARION COUNTY <br />BUILDING INSPECTION <br /> <br /> <br />