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/ MARION COUNTY <br /> 'BUILDING iNSPECTiON DIVISION <br /> · 3150 LANCASTER DR NE- SUITE C <br /> FOR, CiTY yAj.,iDATiONI SALEM OREGON 97305-1398 PERMIT NO :/ <br /> <br /> Re~e~vcd by: I <br /> Date' I , ~ Date: <br />I ' I _...~ hr. ~p~-t~ <br /> omce~Pb~Oam, 4:~Opm [SSU~ by: ~ . <br /> L ' <br /> Ple~e complete ~l ~Eon8, l through ~ ~ - 9 <br /> ~RION COl <br /> I I ~la~d~: lt~ C~ (~h) <br /> <br /> NOHoTRANSFERAB[~/AND EXPIRB IF WORK IS NOT <br />STARTED ~qTH]~ I~) DAYS OY ISSUAI/~ OR. ~ <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br /> 2A. CONTRACTOR INSTALLATION ONLY <br /> <br />Parkin Electric, Inc. 20250 S Molalla Ave. <br />Oregon City, OR 97045 503-657-4958, fax: 557-1059 <br />Contractors License#: 34-4C exp. 113-01-g8 <br />Supervisor: 4241-S exp. 1041-98 <br />Contractors Board Reg#:35151 exp. 10-12-98 <br />MeU'o # 2416 exp. 11-01-98 <br />Owner: <br /> <br /> FOR O ~q]3~ I~]S~ALLA'['I ON S <br />Pmpeay Owner (pleatepti~) <br /> <br /> I <br />Mailing Addrcss I ~e <br /> <br />CitylS~ate/Zip <br /> <br />Owner's Signature: <br /> <br />3. PLAN I~VI]rW SBCTION <br /> <br />Marion County does not requite a plaa review.. <br />We will provide plan review service if you complete <br />Section 5B and subrmt two (2) set~ of plans and <br />specifications with this application. <br /> <br />MC 15.J4 1/96 <br /> <br /> in~t~lhtlm~, ARarat i~x~ or Re~oeation <br /> 200 ~ or ~ $~.~ 2 <br /> ~1 ~m~ $~.~ 2 <br /> ~l~m~ $1~.~ 2 <br /> <br /> ~r I~ ~ ~ ~la ~,~ 2 <br /> R~[ o~y ~.~ 2 <br /> <br /> ~ ~ ~ l~ $35.~ __ 2 <br /> ~ 1 ~ lo ~ ~ Sffi.~ 2 <br /> <br />D. Br~a~ <br /> <br /> a) ~e foe f~ ~c~ui~ ~ <br /> ~m~ae o~ae~i~e ef fe~ fee <br /> ~eh b~ e~ult $ ~ <br /> <br /> b) ~e f~ f~ ~eh ei~ <br /> Fret b~h e~t $35.~ <br /> <br /> S~ e~t(s) ~ a I~ited e~ <br /> <br /> ~ ~ ~n S35.~ <br /> <br /> Pack of 10 I~e~ ~ ~.~ ~ .... $~.~ <br /> (~ d ~y to ~1 <br />H. 0~ <br /> <br /> A~m Dwe~ ~cal ~ ~q. fl- x $.068 = -- <br /> ~g ~k ~ ! ~ ~. N/C <br /> <br />FLIES <br />Al. Emir total o f foc~ from S~. #4 <br />A2. Add 5 ,% aut~a~ge (,05 x Al) <br /> <br />Subtmal $~'~'-' <br /> <br /> <br />