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,o. mc . us . OsLY ] <br />I Received by: . I <br /> -:,~7 ,,. <br /> <br />MARION COIYNTY BUILDING INSPECTION <br />COMMUNITY DEVELOPMENT CENTER <br />~'$~ Chu~h St+ N]E - Room 139 <br />3a1~m, O~son 97301 <br /> <br /> Phone $88-5147 8:00 ~n - 4::30pm <br /> C,~e-A-Phon~: 588-7904 <br /> <br />P~arm[t No. <br /> <br /> E~X= SSS-7~4S SITE #: <br /> ELECTRICAL PERMIT A PLICATION Date: <br />Please complete all Sections, 1 through 5 <br />......... Issued by: <br /> <br /> t.]L~)CATIONOI~IN$'NALLATION q ~ ~ 11 <br /> 4. ~E $CHED~E (C~pl~t~ ~d ~r ~ ~ Al Mow) <br /> ..... I ' "' / ~ Number ~ lnsp~tlons p~ petit allow~ <br /> / <br /> $e~lce Included: ~s Co~l (e~h) <br /> <br /> ~ ~m me.of $15,00 <br /> D~cdp~on E~ Mm~d H~e Or M~uhr <br /> <br /> ~ ~ WO~ ~$ NOT ST~D ~ 180 DAYS O~ ~SU~C~ ~I ~ m 4~ ~ps $~,00 <br /> <br /> ~ct ~y $40,00 ~ 2 <br /> 2A. CO.RAZOR IN~ALLATION ONLY <br /> ....... . ] ..... C. ~m~r~ry Servlce~d~ <br /> 201 ~ps t~ ~0 amp~ $40.00 <br /> <br /> N~,An~a~on, o~ E~ension Per Panel <br /> <br /> b) ~e f~ for ~ch dr~ts <br /> <br /> 2B. FO~ O~E~ I~ALLATIONS ~ch ~Qond bm~ ~t $2.~ <br /> E. M]scellan~us (Servlc~ or Feeder Not Included) <br /> ' Pm~ Owner ~vh ~p ~ ~8a~ d~le $40,00 ~ 2 <br /> <br /> ~Add~ss Ph ~ ~eI, ah~mdon oror ~t~s~n~ne~Y $40.00 <br /> Oty~tatc~p F, ~ch additional Insp~tion <br /> <br /> (~old o~y to ~l~cirical co~ractor~) <br /> O~cfs $ignatu~ ' " H, Other <br /> (Aa ~quired by BuiMin8 <br /> $. PLAN REVIEW tE~ION ,, <br /> <br /> 5. FEES <br /> W~ will provi~ pl~ m~Cw so,ice if you complete S~fion Al. ~t~r ~al of f~es f~ S~c. ,4 } ~ <br /> 5B and submit two (2) ~ of plans and s~ificafions wi~ A2, Add 5% su~ha~: (,05 xAl) <br /> · iS application, <br /> Subm~l <br /> <br /> Thi~ optional plan ~viow pm~ d~s not suspend ~ S. Enter ~% of~c A1 for Plan <br /> rcqut~ submission of lighti~ ~wcr calculations, plans, C, ~vcstigation F~ (ff ~qut~d) $ <br /> and s~ffi~ons when r~uir~ by ~e Oregon S~ct~al D, g,m~ F~ (S~,~) $ ~ <br /> SpeCi~ty C~e, ~apt~ 53. mTXL AMO~ BW $ ~, <br /> <br />MC 15-34 8/94. Recei~ NO' I ......... <br /> <br /> <br />