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'~503 588 7948 <br /> <br />~ 001 <br /> <br />FOR CITY VALIDATION[ <br />Received by: .... <br />Date: <br /> <br />MAR~,IqVJ~IIITY BUILDING,INSPBCTION <br /> ,"]~/~I~Y DEVEI.OPMEN'I CENTER <br /> ~Church St NE ' Room 132 <br /> PERMIT NO: <br /> <br /> Date: <br /> BARION CO Tg,,r .o. Line <br /> <br /> "'-' --'" "~: 588-7948 <br /> <br />'ELECTRICAL PERMIT APPLICATION <br />, Please complete all Sections, 1 through <br /> <br />pERMrr $ AR~t NON-TRANSFERABI~ AND EXPIRE IF WORK l~ NOT <br /> <br /> WOl~[ 1S SUSPENDED FOR Ig0 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />2B. lq'OR OWNER INSTALLATIONS <br /> <br />Prol~rly Owner (plea~eptim) <br /> ........... :-_77/ <br /> <br />City/State/Zip <br /> <br />3. PLANRBVIlqW SECTION <br /> <br />Marion 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 applicaiion. <br /> <br />4. FJ~Iql SCH]~DUL]~ (Complete ami eater Iolal in A 1 below) <br /> Nmnber of luspeclions pe~ p~mit allowed <br /> R~dentia[ <br /> Per <br /> <br />puv:h 6e k 1' sew ye ut ~CLJ'g~ j <br /> <br /> $,%0o 2 <br /> <br />SL~X).(X;, 2 <br />$130,[)0 --- 2 <br />[t00.00 .. 2 <br />$40.00 2 <br /> <br />$35.00 .... 2 <br />$4ono 2 <br />$80.00 .... 2 <br /> <br />$ 2.00 <br /> <br />$40.0D . 2 <br /> <br />$35.00 ---- <br /> <br />$50.00 <br /> <br />/f ~.ff I-~ ~eL~. __ H/C- <br /> <br />FEES <br />A J. E~aer <br />A2. Add 5% sureharge (.05 x Al) <br /> Subtotal <br /> <br />B. Failer 25% of lille A 1 for Plan Review <br /> (See. 3), if requited <br />C. luvesllgalion Fee {iFrequlmd) <br />D. Re~apecfion Fee ($25.~} <br /> <br /> TOTAL ~OU~I' DUE <br /> Receipt No. <br /> <br /> <br />