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· . MARION COUNTY PERMIT <br /> FOR CITY VALIDATION BUILDING INSPECI'ION DIVISION ~u: <br /> <br /> I 3150 Lancastet Dr. ~ - Suite C <br />[Received By: ~1 Salem' OT°n 97305'1398 Date::__ <br /> <br />IDate: I 24 HR laspecfior~[,jn~ 373'4427 <br />~ ~ OtT~'e~ ~h~~am. 4:3~pm [ssucd by: -- <br /> <br /> ELECTRICAL PERMIT APPLICATION /"~.--~ =~ <br /> ^ . ,llt~ 1 7 ~ ~FEESCHEDULE(Comple,eandcntertotali. albelow) <br /> P/ease complete al! ~'ections, 1 through 5 ~uo - - <br /> ....AI ar~esideaflal Per Uail <br /> <br />L LOCATION OF INSTALLATION BUILBtN~I lng1 ~T~.III. o, k,, <br /> <br /> PERMITS ARE NOI~TRANSFERAB LE AND EXPIRE IF WORK IS NOT <br /> STARTED WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WOrK L~ SUSPI~N'DED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br /> l~pcrty Owner (ptea~e pri~uI <br /> Mailing Ad~ ~ <br /> <br /> City, State, Zip <br /> <br />3. PLAN REVIEW b-~CTION <br /> <br />Marion County does noLrequim_a_plan mvZeuc <br />We will provide plan review service if you complete <br />Section SB and s~bmit two (2) sets of plans and <br />specifications wilh this application. <br /> <br />5. FEES <br /> <br /> (Sec. 3), if r~quired $ ~ <br />C. Imvesligat;~a ~ (if ~qui~) $ ~g' <br /> <br /> TOTAL AMOUNT DUE $ ~i~Vs ~"a <br /> <br />MC 15-34 7/97 <br /> <br /> <br />