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VAUOAUO I <br />Reoeivmlby: [ <br />Date: [ <br /> <br /> MARION COUNTY <br />:BUILDING INSPECTION DIVISION <br /> 3150 LANCASTER DR NE - SUITE C <br /> SALEM OREGON 97305-1398 <br /> <br /> /.4 hr. l~spectinn L~e 373-44Z7 <br />Office: Phone :~8-S147 $:00am - 4:30pm <br />FAX: .~8-7~48 <br /> <br />ELECTRICAL PERMIT APPLICATION <br />P/ease complete all Sections, I through <br /> <br />1. LOCATIOH OF' INSTALLATION <br /> <br />~ ~ l~ DAYS OF ISSU~ OR WO~ ~ SUS~ FOR 1~ DAYS. <br /> <br />CONTRACTOR, INSTALLATION ONLY <br /> <br />2B. FOR OWNERll~$TALLATIONS <br /> <br />Pmi~y Owner (pl~s~/~rh~) <br /> <br />City/State/Zip <br /> <br />Owner's Signature: <br /> <br />3. PLANREVIItW SF~WION <br /> <br /> Marion County does not require a plan review. <br /> We w'fll provide plan review service if you complete <br /> Section 5B and subnlit two (2) sets of plans and <br /> specifications with this application. <br /> <br />MC 15-341/96 - <br /> <br />PERMIT NO: <br />Date: <br /> <br />Issuod by: <br /> <br />Al. Emer to~al of fee~ from S~. g4 <br />A~. Add 5% aur~har~ (.05 x A 1) <br /> <br /> <br />