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MARION COUNTY BUI~_DING INSPECTION <br />SENATDR BEDG'.'NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 588-$147 <br />CODE-A-PHONE 4:30 RM. - 8:00 A.M. <br /> <br />BATE: 05/09/89 TIME: 2:36:25p <br /> MARTIN, KlM & DIANE <br /> <br />~FAX LOT: CATE~OF~Y: RESIDENTIAL <br /> <br />11808 15845 DUCK INN ROAD <br />GERVAIS OR 97026 <br /> <br />11848 DUCK INN RD NE <br />GERVAIS, OR~ 97025 <br />PHONE: ?92-4259 <br /> <br />Nc <br /> <br />MARIC~ COUNTY NO <br /> <br />SITE NUNBER: <br /> VALUATION: <br /> <br />4643 <br /> <br /> 95 5S 2N <br />AREA: 28. 0000UNITS: AC IRREG LOT; NO COHNER:NG <br /> <br /> MAP: <br />EFU 18 <br /> <br />TYPE: ELECTRICAL <br /> <br />CONTRACTOR. NO. 6281 <br />LICENSE NO: <br />ENGEL.MAN ELECTRIC <br />P.O. BOX 451 <br />HUBBARD, OREGON 97032 <br />PHONE: 981-6041 <br /> <br />PERHIT OR APPLICATION NO: 15609 <br /> <br /> SUPERVISING ELECTRICIAN/NUMBER <br /> NM. ENGELMAN <br /> <br />TOTAL.r' ~ED' ';FEES <br />PREVI~U8. RECEI P~FS. <br />,THIS'REOE]PT . <br /> <br />BALANCE 'DUE <br /> <br />MC~3ILE HOME SPACE (SVC EQUIP) <br />F~3ILE HOME CONNECTION <br />FLEET SURCHARGE -ZONE 4 <br />ELECTRICAL STATE SURCHARGE <br /> <br />PAYEE: <br />RECEIVED BY: Df4 <br /> .............. <br /> <br />~ THIS IS A V~-ID PEI%'4IT <br /> <br /> NULL ~D ~ID.~ .' ' <br /> <br />RE~ARKS~ ~ SERVICE & ~ ~69~8 <br /> <br />~ALD E. ~DLEY, <br /> <br />qUANTITY <br /> 1 <br /> <br />,RECEIPT NO: <br />CHECK <br /> <br />AHOUNT <br /> ~25.00 <br /> 25.00 <br /> <br /> $2.50 <br /> <br />$57.62 <br />$57.62 <br /> $o.oo <br /> <br />$0.00 <br /> <br /> DATE. IF <br />TO, ,:Fi:'f ALL <br /> THIS PE~4IT <br /> <br />FOHM#MC~5-56 R~V11/88 OFFICE COPY <br /> <br /> <br />