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FOR CITY VAL~T~ATION{ <br /> <br />Date: . [ <br /> <br /> MARION COUNTY <br />!BUILDING INSPECTION DIVISION <br />3150 LANCASTER DR NE - SUITE C <br />SALEM OREGON 97305-1398 <br /> <br />Ofllee: Phone 588-51~7 XS:~am - 4~Opm <br /> F~'t~S-794S <br /> <br />IELECTRICAL PERMIT APPLICATION <br />P/ease complete all $ecgons, I through <br /> <br />1. LOCATION OF ]N~TAI-LATION <br /> <br />PERMITS AI~ ~ON' .'IP~,, ~L~ ~ND l{~U{~[ IF WOR~ I~ NOT <br /> STAR'rI~ ~ 180 nAYS OF ISSUANC~ OR <br /> WORK ~ SUSPENDED FOR 180 DAYS. ] <br /> <br />2A. COi'4TRACTOR ~ALLATiON OiXR.Y <br /> <br />Mmillug Addn~a J Phone <br /> <br />· CitT/S~te/Zip <br /> Owner's $1gnatute: <br /> <br />PERMIT NO ' <br /> <br />Dnto: , ,. ,. <br /> <br />Issued by:, <br /> <br /> 200 an~ or leas $50.00 2 <br /> <br /> · 401 am~ ~o r~o amps $100.00 2 <br /> ' 60!ampstolOOOamp~ $130.00 ' 2 <br /> <br /> Reconnect o~ly $40.00 . 2 <br /> <br /> 200 an~ or ~ $35.00 2 <br /> mt ,~n~ ~ {~,,, s4o.oo 2 <br /> <br /> sec B above'' <br /> <br /> ) ah. t~ t~i~,- <br /> <br /> ~a gcmt': $35.00 <br /> ~cha~aotid6rU~lic~ult ~ $ 2.oo ~ <br />E. Mise~lanmus (~rvlee or peede~ N~ lneluded) <br />Ea~ pump m' ~ citric ~0.00 2 <br />Si~d ci~uil(O o~a limitcd <br /> <br /> 'Ove~ the allowable in any of ihe <br /> <br />$5O.OO <br /> <br />' = - .vq. fi. x $.068 = <br /> # 6fl~oels . N/C <br /> <br /> 3. PLAN RHV~w ~ECTiON <br />] Mari°n'~un, tY"~l°eSnot .require a plan review. <br />{ We will pr°vide'piE xeview ~ if you ComPlete <br />[ SeClio_u ~.B nnd subniit tw° (2) se~'of plato and <br /> <br /> MC 15-341/96 -- <br /> <br />Subtotal <br /> <br /> <br />