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FOR (~ITY VALIDATION <br />Received By: <br /> <br />Date: <br /> <br /> ELECTRICAL PERMIT APPLICATION <br /> Please complete all Sections, I through 5 <br /> <br /> MARION COUNTY <br />BUILDING INSPECTION DIVISION <br /> 3150 Lancaster Dr. NE - Suite C <br /> Salera, Oregon 97305-1398 <br /> <br /> 24 HR Inspection Line 373-4427 <br /> Office: phone 588-5147 8:00am. 4:30pm <br /> FAX 588-7948 <br /> <br />1. LOCATION OF INSTALLATION <br /> <br /> PROPERTY OWNER <br /> <br /> ~ ~ NON-~S~ ~ ~ ~ WO~ IS NOT I <br /> ST~ ~ 1~ DAYS OF ISSU~ OR ~ <br /> WO~ ~ SUSP~ ~R 1~ DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br /> Property Owner (please print) <br /> <br /> Mailing Address <br /> <br /> City, S~e, Zip <br /> <br /> Owner's Signatura <br /> <br />3. PLAN REVIEW SECT/ON <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 application. <br /> <br />MC 15-$4 7/97 <br /> <br />Date: <br /> <br />Issued by: <br /> <br />4. FEE SCHEDULE (Complete and ea~r meal in Al below) <br /> <br />2 <br /> <br />2 <br />2 <br />2 <br /> <br />2 <br /> <br />5. FEES <br /> <br />B. Enter 25% of linc Al for Plan Review <br /> (Sec. 3), if required <br />C. {nveafigation Fee (if requked) <br />D. Reinspeetion Fee ($25.00) <br /> <br />Receipt No. <br /> <br />Subtotal <br /> <br />TOTAL AMOUNT DUE <br /> <br /> <br />