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LICENSE ELECTRICAL LOG <br /> • MARION COUNTY DEPARTMENT OF PUBLIC WORKS <br /> BUILDING INSPECTION DIVISION <br /> 5155 SILVERTON RD NE <br /> SALEM,OREGON 97305 <br /> PHONE#(503)588-5147 <br /> FAX#(503)588-7948 <br /> MASTER ELECTRICAL PERMIT <br /> LICENSE LOG <br /> PLANT NAME Wilbur Ellis PHONE#: 503-981-3521 <br /> PLANT LOCATION: 868 N Front St,Woodburn, OR 97071 FAX#: <br /> MAILING ADDRESS: Same <br /> CITY: STATE ZIP <br /> TYPE OF STRUCTURE: Commercial Warehouse and Office Space <br /> TYPE OF BLDG USE: <br /> SUPERVISING ELECTRICIAN: Kevin Burdine 6136S <br /> CONTACT PHONE#: 503-566-5600 <br /> DATE NAME LICENSE#/TYPE EXPIRATION DATE <br /> • <br /> 9-17-2018 Darren Tharp 22258J 10-1-21 <br /> SIGNATURE OWNER/SUPERVISOR: DATE: <br /> I UNDERSTAND THAT THE MASTER PERMIT INSPECTION FEE IS$67.25+12%STATE <br /> SURCHARGE/HOUR PORTAL-TO-PORTAL,(MINIMUM ONE HOUR FOR A TOTAL OF$75.32). <br /> PAYABLE PRIOR TO THE RELEASE OF THE INSPECTION REPORT.(OAR 918-309-0100.) <br /> • Complete this form and return it to Building Inspection Division. The Electrical Inspector will contact you to schedule a <br /> date and time for your inspection. <br /> G:1Master Permits\License Eieotrical Log.doc 4/18 <br />