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MARION COUNTY BUILDING INSPflCTION <br /> <br />Received by: ... .__ 97301 <br /> Office: Phone ~88-$147 8:OOam - 4:30pm <br /> MARI[~N COUNT~Ax: sss-~948 Issued by: <br /> <br />ELECTRICAL PERMIT APPII~I.61KgI~I~S~ECTION <br />Please complete all ,~ections, I through ,5 1 4. I~B~, .~lc[--I~)I. JI,~ (Complete and ent~ total in A] below) <br /> <br />1o LOCATION OF INETALLATION <br /> <br />2A, CONTRACTOR INSTALLATION ONLY <br /> <br />~. FO~ 0~ ~T~LATIONS~ <br /> <br />PLAN REVIEW SHCTION <br /> <br />Marion County does not require a plan review. <br />We will provide plan review service if you complete <br />Section 5B and submit two (2) sets of plans and <br />specifications with this application. <br /> <br />$ 2.00 --~ <br /> <br />$35,~ <br /> <br />E. Miscellaneous (Servi~e ~' Peede~ No~ Inc~d~) <br />~ch p~p ~ ~gat~n c~le ~.~ 2 <br />~ ai~ or outline li~g ~.~ 2 <br />51gn~ c~t(s) or a limit~ ~ <br />~el, nitration or ex,ion ~.~ ~ 2 <br />F. Ea~ a~itio~l i~lon <br />O~r ~e allowable ~ ~y of ~e <br />a~ve, ~r ~p~tion ~5.~ <br />O, Min~ InaCtion Labels <br />Pack of 10 Inbeh ~ ~.~ ~ch $~.~ <br /> <br />H. Oth~ <br />(~ req~red ~ ~ild~ O~D <br />A~ ~elling ~l~eal F~ ,~q. fl, x $.0~ = ~ <br /> ~ling P~it ~1 g of ~. ~ <br /> <br />5. PEEI~ <br />A 1. Enter total of fees from Se~.//4 $~-.-/~ O~ <br />A2. Add 5% surcharge (.05 x Al) <br /> ~ubtotal $.__ <br /> <br /> B. ~t~r25~ ofl~eAl for PlanReview <br /> (See. 3), if ~qu~ $.~ <br /> C. lnwstiga~on Fee (ifr~d) $.~ <br /> D. Reimpection ~e ($25.,)~ ~0~ D~$~$~ <br /> <br /> Receipt No. <br /> <br />MC 15-34 1/96 <br /> <br /> <br />