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87/82/1999 12:84 <br /> <br />FOR C~TY USE ONt-Y <br /> <br />:ELECTRICA[~ PERMIT AJ~FLIC^TtON <br />PIg~g ce~el~, ell $~i~, I ~r~g~t $ ' <br /> <br />Zip; <br /> <br /> Irlc. 20250 $ MolalJa Ave, <br />OR a7045 503-657-4958 fax: 557-1059 <br /> 3~.4C eXP. <br /> <br />8:00 am - 4:30 pm <br /> <br /> M~loa cou~rr~ aUILOI~- <br /> 3150 L~31 S0 ~r Dr. ~ - Su~ C <br /> ~m, 0~ 97305 <br /> 24 ~. ~i~ L~e 3~3~27 F~ 588-794g <br /> <br /> Num~ ofh=~;~ ~ ~it allo~ <br /> <br />200am~l~ ~ ~ ~65~0 = S 2 <br /> <br />601am~ml0O0am~ ~ x SZ70.00- S .2 <br />~ I~VOlU x $390,~ <br /> <br />401 am~ m 600 a~ <br /> <br /> The ~ f~r b~h c~ula ~ <br /> <br /> bccllaaeous (~iee or Peter Nor <br /> pump ~ J~an <br /> Si~ or Outl/~ Li~6B <br /> <br /> ~ck Of 10 la~Js ~ S10,00 m~ <br /> (S~ld ~nly La 51~1 <br /> <br />On~ ~lmlly D~llini Fee: Sq, F~ <br /> <br />O~{ER. as required by th* Bulldlll O~cMI <br />TOTAL S <br /> <br />S. FEES <br />Al. Enter Tota~ Fecs ~m Section #4 <br />A2 Add Stare Sumhatge (.05% x Al} <br /> <br />SUBTOTAL: S <br /> <br /> B, Entcr30%oflineAI forPhn P,~viaw <br /> <br /> m~um onu~fhou0 <br /> F. lns~ction ~or which no fee is <br /> (Sf2.50~r, minimum one houO $ <br />. ~. lns~ction OuBid~ No~ Bas,ess Hou~ <br />'. S62.~0~r, mln~um ~o hou~) <br /> <br /> <br />