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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 588-5147 <br /> CODE-A-PHONE 4::80 P,M, - 8:00 A.M. <br /> <br />I am a registered builder OR the authorized representgtive SIGNATURE OF APPLI <br />of a registered builder, <br />The work will be performed by a registered builder, <br />other. <br />DATE: <br /> <br /> this document. <br /> <br />BATE: 10/23/87 TIME: 1:17:28p <br /> <br /> 14OOORUM, AUSTIN <br /> <br />SITgS ADDRESS; <br /> <br /> 8711 HOLMQUIST RD <br />: AUMSVILLE Or 97325 <br /> <br />USE OF ~UILDING~ <br /> <br /> RESZDENTIAL ACO~RY .ST~C~i~E~ <br /> <br /> SA~E <br /> <br /> PHONE: 749-2830 <br /> <br />WIs'CH: :DEPTH'. <br /> <br /> SITE NUMBER: 2922 <br /> VALUAT I ON: <br /> <br />AREA: UNITS; I IRREG. LOT: NO iCORf~: <br /> <br />TYPE: ELECTRICAL PERNIT OR APPLICATION NO: <br /> <br />5205 <br /> <br />CONTP-4~CTOR, NO. <br />LICENSE NO~ <br />NOODRUM, AUSTIN <br /> <br />E~JPERVISING ELECTRICIAN/NUMBER <br /> <br />PHONE: 749-2330 <br /> <br /> ITEH <br />SERV CHANGE ONLY-EXISTING RE;SIDENCE <br />FLEET SURCHARGE -ZONE 3 <br />ELECTRICAL STATE SURCHARGE ,, <br /> i?:TOTAL';AE4.S~EDFE~ <br /> ::: :::PREV I'OUS! REOE I PTS <br /> ]: THIS RECEIPT <br /> <br />(~JANTITY ~'IOUNT <br /> $20.00 <br /> $3.84 <br /> $~.00 <br /> <br />$24.84 <br /> $0.00 <br />$24.84 <br /> <br />$0.00 ~ <br /> <br />REMARKS: SERV. CHG <br /> <br />DONALD E. NOODLEY, r4ARION COUNTY BUILDING OFFICIAL/;BY <br /> <br />FORM ,, MC 1 5'~6 ~VI e/e~ OFFICE COPY <br /> <br /> <br />