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MARION COUNTY BLqLDING INSPBCTION <br /> <br />FOR CIT~ ~A~JDATION.I ^ <br />]Date: tit) ~',d~'7 ' , I ~ <br /> ' ~ '1 I ' <br /> <br />COMMUNITY DEVELOPMENT CENTER <br />28.5 Church St NE · Room 132 <br /> Salem, OR 97301 <br /> <br />24 Hr inspe~tion Liae: 588-7904 <br /> <br />PERMIT NO: <br />Date: <br /> <br />Description <br /> <br />B. Se~,dve~ o~ Feeders (Does not include branch circuits, see section D) <br /> Inslaaat/on,-Altm'atien ~ Re~Uien <br /> <br /> b) ~e f~ for ~nch ci~uil~ wi~ut <br /> <br /> ~er t~ all.able in any of~e <br /> <br />5. FEE8 <br /> A L ~ lo,al o~t~en from Sg. ~4 <br /> ~. A~ 5% sug~ 605 x <br /> ~bt~al <br /> <br /> R. ~t~t 25% ~ ~ Al Cot Pla~ Review <br /> (~c, 3), if gqui~d <br /> C. l~es~ga~n Fee <br /> D. ~impect~n Fee ($~.~) <br /> <br /> ~T~ ~0~ DUE <br /> Receipt ~o. <br /> <br />PERMITS ARE NON-TRANSFERABLE AND EXPIRE IF WORK IS NOT <br />STARTle) V~ITHIN 1~0 DAYS OF ISSUANCE OR fF <br /> WORK IS SUSPENDED FOR 180 DAYS, <br /> <br />2A. CONTRACTOR INSTALLATION' ONLY <br /> <br />Maitk,g Address <br /> q <br /> <br />Supervisor's License No. J Phone <br /> <br />2B. FOR OWN'ER INSTALLAT'qON$ <br /> <br />3. PLANREVIEW $tiCTION <br /> <br />JMarion County does not require a plan review. <br /> We will provide plan review service if you complete <br /> Section 5B and submit two (2) sets of plans and <br /> specifications with this application. <br /> <br />MC 15-34 1.7./94 <br /> <br /> 2 <br /> 2 <br /> 2 <br /> 2 <br />.2 <br /> 2 <br /> <br />2 <br />2 <br />2 <br /> <br /> Office: 588-5147 8t00 a.m. - 4:30 p~n. 188UI!K:I by: <br /> FAX' 588-7948__ <br /> <br />ELECTRICAL <br /> PERMIT <br /> APPLICAT~,~r-,~_~'~t'"'~r-~'e'~w , .. <br /> <br /> -~-- ~ ~ ' ~'~'~ ~ ~Ma~fac~H~eorM~ <br />D~t~m ~dling S~i~ or ~ed~ $~.~ 2 <br /> <br /> <br />