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FOR OmCE USE ONLY <br /> <br />D~te: <br /> <br />MARION COUN'I~ BUILDING INSPECTION <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete all Sections, I through 5 <br /> <br />Permit No. <br /> <br />L LOCATION OFIN,~TALIATION <br />lob Add.ss <br /> <br />PIiRMIT~ AP~ NON.~ AIqD NON-RBNUNDABL}{ AND { <br />RXPIRI{ IF WORK IS NOT ~yARTI{D WITHIN 180 DAY{ OF ISSUANC]{ <br />OR IF WORK I~ SUSPI{ND~D FOR 180 DAYS. <br /> <br />iA. CONTRACTOK .I~AI~TION ONLY <br /> ', i <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br />P~ O~zr <br /> <br />~. PL&N REVIEW SgCTION <br /> <br />We will provide plan review service if you complo~° $oclion <br />5B a~d s-bmit two (2) sea of plans and specificafious wi~h <br /> <br />This optional plan review program does nor suspend <br />required submission o~ lighdng power calculalion~ plaas, <br />and specifications when required by the Ore~on $ix~ca~al <br />$1x~tal~, Code, ChapU~r 53. <br /> <br />MC 15-,14 <br /> <br />~ Co~t (~ch) Sum <br /> SSS.00 4 <br /> <br /> $1s.oo <br /> $2o.oo , 1 <br /> <br />$2.00 <br /> <br />$2.00 <br /> <br />No. <br /> <br /> 2 <br />2 <br /> 2 <br />,2 <br /> 2 <br /> 2 <br /> <br /> <br />