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Roceived by:. <br />l~te: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> 3150 Lancaster Dr NE, Suite C <br /> Salem OR 97305-1398 <br /> <br /> 24 hr. Inspection Line 373-4427 <br />Otlice: Phoae585-5147 S:OOam-4:3Opm <br />FAX: 588-7948 <br /> <br />ELECTRICAL PERMIT APPLICATION ] <br />Please complete ali Sections, I through 5 <br /> I <br /> <br />1. LOCATION OF IN~rALLAT[ON <br /> <br /> .~ ~ <br /> ~ A~ HON-~NS~B~ ~D ~l~ IF WO~ IS NOT ] <br /> ~ ~ I ~ DAYS OF ISSUAN~ OR IF <br /> WO~ IS SUS~D~ ~R I~ DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br /> FOR O~N~R <br /> <br />Ftopmy Owner (plets~ pti~t) <br /> <br />Mailing Addcess J I~hone <br />City/Sate/Zip <br />Owner's Signature: <br /> <br />3. PLAN RE'vIEW SBCTION <br /> <br /> Marion County does not require a plan review. <br />We will provide plan review ~ervice if you complete <br />Section 5B and submit two (2) sets of plans and <br />specifications with this application. <br /> <br />MC I~-~d <br /> <br />PEP, MW NO: <br /> <br />Date:, <br /> <br />Issued by: <br /> <br /> b) The lee tee bcanch circuits wilhout <br /> <br /> Fint bcwxh ci~uit <br /> Each addit kraal branch circuit <br /> <br /> Misedlafleoos (~vleo ~ Feeder Not lnclude~) <br /> Each pump ~ irclgnlion Circle <br /> Each sign oc outline Ii,ling <br /> S~md ci(c~(s) or · limited <br /> panel, altemioa or ext~iea <br /> Each additlo~sl Inspeetion <br /> Over the allowable in any of the <br /> <br />O. ~ac~ [n~llatlon <br /> Pack of 10 labels ~ $5.00 tach. <br /> (sold only to dec, dca I <br /> <br /> (.~ re~t~ed by Build~ <br /> Aumm Dwelling Electtlc·l Fee <br /> DweUing Pem~il. Labd <br /> <br />$35.~ <br />$2.OO <br /> <br />$40.00 2 <br />~0.00 2 <br /> <br />$40.00 ~2 <br /> <br />$35.00 -- <br /> <br />%5O.OO <br /> <br /> sq. fl. x $.0~ = -- <br />I of Labels. NIC <br /> <br /> <br />