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FOR CITY VALIDATION <br />Re~eiwd by: <br />Date: <br /> <br />MARION COU1VTY BUILDING INSPIIgCTiOBI'~~.~. <br /> COMMUNITY DEVEL;O, PMENT cENTER <br /> <br /> Date: ["~ 23 <br /> 24 Hr friction Lin~ 588-7904 . _~.~,- MARION COUNTy <br /> Off`ice: 588-514'7 <br /> FAX: 588-7948 tsauutl::~i'[rll~t~ <br /> .... "vorcL, llUN <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete ,all.Sections, I through 5 <br /> <br /> P~RMITS AR~ NON-TRANSFeRABLE AND EXPIRE IF WORK <br /> STARTED WITHIN 1~0 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOE 180 DAYS- <br /> <br />2A. CONTRACTOR ~ISTALLATION ONLy <br /> <br />Parkin Electric, Inc. 20250 S Molalla Ave, hone <br />Oregon City. OR 97045 503-65%4958 <br />Contractors License #: 34-4C <br />Supervisor #; 1313-S sene <br />Cox~tractors Board Reg # 35151 <br /> <br />211. FOR OWNI~R INSTALLATIONS <br /> <br />3- PLANREVIRW SECTION <br /> <br />Marion County does not require a plan review. <br />We will provide plan review ~ervice ffyou complete <br />Section 5It and submit two (2) sets of plans and <br />specifications with this application. <br /> <br />MC' I.q-34 12/94 <br /> <br /> 4. Fgl~ $CH][tD'O?[,Itl (Complete and ent~r total in A I bcbw) <br /> <br /> m t <br /> <br />I Limited ~crgy $20.~ ~ <br /> <br />I '~ ~a~tion, ~t~ati~ or Rol~ti~ ~ <br /> ~0 am~ or less ~ $50,00 ~. 2 <br /> <br /> ~ amps or 1~ $35,~ ~ 2 <br /> ~1 amps to ~ amps $~.~ ~ 2 <br /> <br /> ¢imuR ~ $ 2.00 ~ <br /> ~ pump ~ iffigation cimlo ~.~ ~2 <br /> <br />Al. Enter tolal of fees from ~.//4 $ <br />A2. Add 5% surcharge (.05 X A 1) $ <br /> gubtotal $.__ <br /> <br />B. Enter 25% of line A 1 for Plan Review <br />(S~c. 3), if requited $.__ <br />C, Investigation Fee (ifr~qulr~d) $.__ <br />D, Relmp~otion Fee ($25,00) $_ __ , <br /> <br />Receipt No ........ TOTAL A/VlOUNT DUE $~/./~l>O,/'~ '~ <br /> / <br /> <br /> <br />