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FOR CITY VALIDATION] <br /> <br />Date: . ] <br /> <br /> MARION COUNTY <br />· iBUILDING INSPECTION DIVISION <br /> 3150 LANCASTER DR NE - SUITE C <br /> SALEM OREGON 97305-1398 <br /> <br />IELECTRICAL PERMIT APPLICATION <br />Please complete all ,~ections, I through <br /> <br /> L LOCATION OF I~TALLATION <br /> <br />Cross 5tl'ec~Dircctioi~l: <br /> <br /> CONTRACTOR 1NSTAT.L~TION ONLY <br /> <br />Conwaciors'Licc[~e No. <br /> <br />Contractor,s Boaxl F~g No. <br />Signauire of Supervisiug Elecuicia~ <br />Supervisor's License No <br /> <br />Phoneg <br /> <br />3: PLAN:P-..ti¥11tW ~IECTION <br /> <br />we waiiFo &'p t'*%w if you' comPlete <br />$~q,:{~B .and submit two (2)sets of plans and <br />SPecifications with tliis aPPlication <br /> <br />MC 15-3411P6 ~ <br /> <br />PERMIT NO: . <br /> <br />Date: . <br /> <br />Issued by: <br /> <br />Al. F.~r Iotal ~ f f~.~ from S cc: fi4 S <br />~ A~ 5% a~ (.05 x Al) $-- <br /> <br /> Q. <br /> $ <br /> <br /> <br />