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FOR CITY VALIDATION <br />Received <br />Dato: <br /> <br />MARION COUNTY BUILDING INSPECTION <br />COMMUNITY DEVELOPMENT CENTER <br />285 Church St NE · Room 132 <br /> Salem, OR 97301 <br /> <br />24 Hr Inspcctlon Line: 588-7904 <br />Office: 588-5147 8:00a.m_-4:30p,m, <br />FAX: 588~794a <br /> <br />ELECTRICAL PERMIT APPLICATION <br />P/ease complete all Sections, I through <br /> <br />1. LOCATION OF iNSTALLATION <br /> <br />PEP. MITS ARE NON-TRANSFERABLE AND EXPIRE IF VqORK IS NOT <br />STARTED WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR 1150 DAYS, <br /> <br />2A, CONTRACTOR LNSTALLATION ONLY <br /> <br />2~, FOR OWNER iNSTALLATIONS <br /> <br />Phone <br /> <br />3, PLAN REVIEW SECTION <br /> <br />[Markm County does not require a plan review, <br /> We will tlrovide plan review service if you complete <br /> Section 5B and submit two (2) sets {If plans and <br /> specifications with this application <br /> <br />12/94 <br /> <br /> q 5-ioq-q& <br />PERMIT NO · <br /> <br />Date: <br /> <br />Issued by: <br /> <br />4. FIlE SCHBDIJLE (Complete and enter total in Al b¢lov0 <br /> <br />A.. <br /> Rt~eide~t iai <br /> <br />I()~ ~q. ft or less $85~ 4 <br /> <br /> 401 amp~ lo G)0 ainp~ $ I~)~ __ 2 <br /> <br /> ~0 am~ or less $3500 ~_ 2 <br /> 201 am~ to 400 aml~ $~00 ~ 2 <br /> <br />$35 00 <br />$ 200 <br /> <br />$4000 2 <br />$4000 ......... 2 <br /> <br />Sag) 0(I 2 <br /> <br />$5000 <br /> <br /># ot Labela NlG _ <br /> <br />5, FEEg <br /> <br /> (SeC 3)~ i~ relluxred <br /> <br /> D Rem~pcctton Fee ($2500) <br /> <br /> TOTAL AMOUNT DUE <br /> <br /> <br />