Laserfiche WebLink
PLANT NAME: <br /> <br />PLANT LOCATION: <br /> <br />MAILING ADDRESS: <br /> <br />CITY, ST, ZIP: <br /> <br />MARION COUNTY BUILDING INSPECTION <br />285 CHURCH ST NE - ROOM 132 <br /> SALEM, OREGON 97301 <br /> PHONE # (503) 588-5147 <br /> <br />INDUSTRIAL PLANT ELECTRICAL INSPECTION <br /> LICENSE LOG <br /> <br />PHONE #: <br />SITE #: <br /> <br />'p.a. <br /> <br />TYPE OF STRUCTURE: <br />TYPE OF BLDG USE: <br /> <br />SUPERVISING ELECTRICIAN: <br />CONTACT PHONE #: <br /> <br />(..$n~'~ '7'qq-lq°° <br /> <br /> LICENSE LOG <br /> <br />DATE NAME LICENSE # / TYPE <br /> <br />EXPIRATION DATE <br /> <br />I UNDERSTAND THAT THE SPECIAL INSPECTION FEE IS $50.001HOUR PORTAL-TO-PORT/~,L, <br />(MINIMUM ONE HOUR), PAYABLE PRIOR TO THE RELEASE OF THE INSPECTION REPORT. <br />OAR 918-260-190 (4). <br /> <br />SIGNATURE OWNER/SUPERVISOR: /--'~ ,~- <~¢,,-..~ <br /> <br />Complete this form and return to Building Inspection prior to inspection. <br />schedule date and time of inspection. <br /> <br /> DATE: ~ <br />Inspector will contact you to <br /> <br />LIC. LOG 12/98 <br /> <br /> <br />