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MARION COUNTY <br />BUILDING INSPECTION DIVISION <br />3150 LANCASTER DR NE- SUITE C <br /> <br />.q <br /> <br /> FOR CITYVAIJDATION[ SALEM OREGON 97305-1398 PERMITNO:, <br /> <br /> Re~elved by: [ : ..; ....... <br /> <br /> Date: ~~' I , ,~g > v--:.'.: Date: , ,..._. _ <br /> <br /> i Olllce. PhS,ie= ' '30pm . <br /> <br />I ELECTRICAL PERMITAPPLICA'II~.~a~'¥~ '"~ '~ .. ' <br /> Please complete all Sections, I through.......,- , ~ ~?. i,J~ SCi~iYT~]~ (co~,-,~,~,., ~ ^t,,~,,. <br /> 'bd -- ' ~d~l~l P~ Ogt · <br /> 1. LOCATION OF ~~ON ~.~ ~ ~ l,~d~i <br /> <br />PERMITS A RE N"ON' ~'T~AN' ' sFERABLE AND IDgPlllE IF WORK 1~ NOT ! <br /> STARTED WITHIN tS0 DAYS OF [SSUANOE[ OR IF <br /> WORK [S SUSPENDED FOR IS0 DAYS. <br /> <br />:lA. CONTRACTOR I~TALLATION ONLY <br /> <br />ZB. F OR O ~Fflu~. ll~ISTAT .~ -&TIONS <br /> <br />P.e<xin~ct only <br /> <br />> i=d~lla t io~;Al~/tioo. ~ Relocation <br /> <br /> $5ox)o,.~L2 <br />$60..00 2 <br />$100.00 2 <br />$130.00 2 <br />$300.00 2 <br /> <br />$35.00 <br />$ 2.00 <br /> <br /> <br />