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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 /> PLANTNAME City of Woodburn PHONE#: 503-982-5222 <br /> PLANT LOCATION: 270 Montgomery Street FAX#: <br /> MAILINGADDRESS: <br /> CITY: Woodburn STATE OR ZIP 97071 <br /> TYPE OF STRUCTURE: <br /> TYPE OF BLDG USE: <br /> SUPERVISING ELECTRICIAN: Ron Thunderbird <br /> CONTACT PHONE#: 503-981-8041 <br /> DATE NAME LICENSE#ffYPE EXPIRATION DATE <br /> • Ron Thunderbird 4739 S 10/1/22 <br /> Daniel Dummer 4449 S 10/1/22 <br /> Mark Holum 4447 S 10/01/22 <br /> Peter Beyer 19642 J 10/01/21 <br /> Seth Fisher 18922J 10/01/21 <br /> Mark Barbano 27765 J 10/01/21 <br /> Erik Mariaca 28555 J 10/01/21 <br /> SIGNATUREOWNER/SUPERVISOR: /t9ZCADlf- DATE: 01/22/21 <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 Electrical Log.doc 4/18 <br />