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FOR CITY VALIDATION <br />Received by:, __ <br />Date: <br /> <br />SALEM OREGON 97305-1398 PERMff NO: _ <br /> MARION ~O~,U~TY <br /> ~4 ~. ~,t,~,:~o. n.. 373-44~UILDING I~C,,~,, <br /> ~: p~ ~51~7 8:OOam - 4:30pm <br /> ~ ~8 Issu~ by: <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete all ~ections, I through <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />PERMITS AP~ NON-TRANSFERABLE AND EXP[I~ IF WORK IS NOT <br />STARTED ~ 180 DAYS OF ISSUANCI[ OR IF <br /> WORK I$ SUSPENDP'r) FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INErALLATION ONLY <br /> <br /> Parkin Electric, Inc. 20250 S MolelIa Ave. <br /> Oregon City, OR 97045 503-657-4958 fax: 557-10,59 <br /> Contractors License #: 34-4C exp. 10-01-97 <br /> Supervisor: 424'1-$ exp. 10-01-98 <br /> Contractors Board Reg #: 35151 exp. 10-12-98 <br /> Metro# 2416 exp. 11-01-97 <br /> Owner: <br /> <br />23. FOR OWNER INSTALLATIONS <br /> <br />Marion County does not require a plan review. <br />We will provide plan review se~ice if you complete <br />Section 5B and subn~it two (2) sets of plans and <br />specifications with this application. <br /> <br />MC 15-$41/96 <br /> <br /> I~talhtloa, Al~'atioe o~ Reloe~tioa <br /> 200 ~ or I~ $~.~ 2 <br /> ~1 ~ lo ~ m~ $~.~ 2 <br /> ~l~to~ $1~ 2 <br /> ~1 ~ to I~ ~ $1~.~ 2 <br /> ~ t~ ~t~ ~.~ 2 <br /> ~t o~y · ~.~ -. 2 <br /> <br />C. T~ary <br />~t~ ~at~. ~ R~tion <br />~or~ ~5~ 2 <br /> <br /> ~1 ~ ~ ~-m~ $~.~ ~ 2 <br /> ~r ~ ~ or 1~ <br /> <br /> N~; ~at~ ~ E~ P~ Pend <br /> a) ~e fee f~ b~ c~uia ~ <br /> <br /> b) ~e f~ f~ ~ gi~ wi~out <br /> <br /> ~t brach c~t <br /> ~ ad~fion~ b~h civet $ 2.~ <br /> <br /> ~ si~ ~ ou~ fi~ $~.~ 2 <br /> <br /> ~r ~ all~ab~ ~ ~y o~ ~e <br /> ~v~ ~ ~a S35~ <br /> <br /> PaCk of 10 ~b ~ $5~ ~ch $~.~ <br /> (~d ~y to ~1 <br />~ 0~ <br /> <br /> A~ DweB~ ~cal F~ sq. ~. x $.068 = <br /> ~ P~t ~ ff df ~ N/C <br /> <br /> B, Eat~r25% ofliaoAl forPlnnReview <br /> (s~. 3), if r~luk~l $.__ <br /> C. [aveagption r~e {ifr~quimd) $.__ <br /> D. l~i~p~,clio= Fc~ (r/.5.00) $,__ <br /> <br />· R~ipt No, <br /> <br /> <br />