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• LICENSE ELECTRICAL LOG <br /> MARION COUNTY DEPARTMENT OF PUBLIC MOMS <br /> BUILDING INSPECTION DIVISION <br /> 5155 SILVERTON RD NE <br /> SALEM,OREGON 97305 <br /> PHONE 8!(503)5118-5147 <br /> FAX Ir(543)588-7948 <br /> MASTER ELECTRICAL PERMIT <br /> LICENSE LOG <br /> PLANT NAME CA \ ri—L3 PLANT <br /> - <br /> PLANT LOCATION FAX <br /> MAILING ADDRESS: <br /> CITY: STATE ZIP <br /> TYPE OF STRUCTURE: <br /> TYPE OF BLDG USE: 113 )—(7-5 ICO 2 Co <br /> SUPERVISING ELECTRICIAN: kj AA SC,kAC1....Ve,k,,- <br /> CONTACT PHONE 4' cccc( 32 <br /> • DATE 'SAME LICENSE titTYPE EXPIRATION DATE <br /> KOV11,3 Toot, . Zz7,42,Z. Pjoi4Z-1___ <br /> SIGNATURE OWNER SUPERVISOR: DATE: I / R /2.ik <br /> I UNDERSTAND THAT THE MASTER PERMIT INSPECTION FEE IS$67.25+11%STATE <br /> SURCHARGE/HOUR PORTAL-TO-PORTAL(MINIMUM ONE HOUR FOR A TOTAL OF S15.32). <br /> PAYABLE PRIOR TO THE RELEASE OF THE INSPECTION REPORT.(OAR 911-389-0100.) <br /> \'-- Complete this form and return it to Building Inspection Division. The Electrical Inspector will contact ou to schedule a <br /> date and time for your inspection. <br /> Cr'Mrsier Permits ix-erne Flearvat Lot We 4,1 <br />