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". !BUILDING INSPECTION DIVIS({~I~ <br /> 3150 LANCASTER DR bE k~L)IA'EC ~q'~ '' <br />[ MOR C~Y VALmA~ON~ SALEM OREGON 9~,~8 5~ ~ . p~ NO'~ <br /> <br />ELECTRICAL PERMIT APPLICATION <br />P/ease complete all ~t/ons, I through <br /> <br />1. LOCATION OF ~STALLATION <br /> <br />~ A~ N..ON- .~-n~5~.... s~ ~ ~o, nu~ ~ wog~c is Nor <br />STAI/.TE~ ~ Im DAYS OF ISSUANCF- OR I~ ' <br /> W~EK I~ SUSPEh'DED FOP, [80 DAYS. <br /> <br />2A. CONTRACTOR'~BTALLATION ONLY <br /> <br />2.B. ]FOR OWN/SF. I~ST, ALL&TIOI'IS <br /> <br />/¢,ailiag Addm~ I <br /> <br />Owner's $ign~um: <br /> <br />: Ma/ion"'~mity:!~Oe~ iibt!~uire a plan review. <br /> W~'.W'iii;~J~o Vid ~!~Ji~ '~,-~&'~i~' i~ you ~omphte <br /> <br /> speafic~itioas with tliis ap~hcation. <br /> <br /> <br />