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Other <br /> <br /> 9533 GOLF CLUB RD ~E ~ CONTRACt CITY; [ UGB; : OCCUPANT ~OAD: <br />AUMSVI LLE OR 97325 <br /> <br /> LiNDA SAMEK <br /> 14008 TRIUMPH RD SE SUBL. 97385 <br /> PHONE: ?69-?035 <br /> <br />LOT: '~LO:K: iS~Ti~: <br /> <br />SUBDIVISION; <br /> <br /> SITE NU~ER: 3887 <br /> [ ~(~WNSHIP'. 'l RANGE; <br /> <br />DEPTH: AREA; ~ UNITS: <br /> i 1.2..5000,, ~ AC ~ NC NC <br /> <br />TYPE: ELECTRICAL PERMIT OR APPLICATION NO; 7885 <br /> <br />CONTRACTOR, NO. 505?0 SUPERVISING ELECTRICIAN/NUMBER <br />LICENSE NO: GEO~E PLANE/26-?S <br />GRR ELECTRICAL. ZNC, <br />1~'! S. NADZSON ST. <br />5ILVERTON ORE~N 97381 <br />PHONE; 873-4880 <br /> <br /> I T EM QUANT l TV AMOUNT <br /> <br />PLEET SURCHARGE ~ZONE 3 $3_84 <br />ELECTRICAL STATE SU~HARGE <br /> <br /> TO%AL :A~E~E~ FEES $56.34 <br /> <br /> RECEIPT NO: 9515 <br />PAYEE: GRR ELECTRICAL. INC. <br />RECEIVED 8Y~ CL , ::. ~PE: CK CHECK ~; 1685 <br />m ~IS IS A VALID PE~IT m 180 :~ F~ :ITS I~E ~TE. IF <br />~T~CTI~ C~ FOR A PERIOD::OF 180 ~. OR IF, ~T~CTI~ FAI~ TO ME~ ALL <br />~ALL BEdE NULL ~D ~ID.: ' <br /> <br /> qW80 <br />RE~ARKS~ 200 A~P , , <br /> <br />DONALD E. MOODL, EY. <br /> <br />~ORM · MS 1~'56 R~¥ 0/07 OFFICE COPY <br /> <br /> <br />