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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 4:30 P.M., 8:00 A.M: <br /> <br />Other. <br /> <br />JACK ~ RESIDENTIAL <br /> <br /> 6104 ,.'.'.'.'.'.'.'.'.~d~ LANE SE........................ <br /> AUJ~4SVILLE OR 9?325 CONTRACT CITY'. i UGS: IOCCUPANT LOAD: <br /> <br />~,u~ ADOR,SS: ...................... ~ ~6~;~,~i6~: .......................................................... <br /> <br /> ~E: 749-2941 SITE NU~ER: <br /> <br /> ,SEC~I~: ;TOWNSHIP; RANGE'· ION/'. MAP: <br /> <br /> 24 ' 8S 2N ' AR3 51 <br /> : ................. , .........,..~,.~.,. ,.., ~,,,,, ,,,, ~,,~ ....................... , .... <br /> <br /> 1~0900. ~F NO ; NO <br /> <br />:LO+: :UL6a~: <br />I 175~! 748 <br /> <br />TYPE: ELECTRICAL <br /> <br />CONTRACTOR, NO. <br />LZCENSE NO: <br />PACIFIC COAST ELEC., INC+ <br />P.O. SOX 651 <br />STAY'TON, OR 97383 <br />PHONE: 769-7671 <br /> <br /> PEP, NIT OR APPLICATION NO: Cl1062 ) <br />45933 SUPERVISING ELECTRICI AN/NUIVE~ER <br /> LEONARD IVlYER;~ <br /> <br />,: $o.oo <br /> <br />MC~ILE HC~IE SPACE (SVC <br />HOBILE HONE CONNECTION <br />FLEET SURCHARGE -ZONE <br />ELECTRICAL STATE ,~URCHARGE <br /> <br /> qUANTITY AJ~,~UNT <br /> 1 $20.00 <br /> 1 $20.00 <br /> $3.84 <br /> $2.00 <br />TOTAI~ AS~ES'sED "FEES $45.8¢ <br />PREVIOUS RECE':~'PTs $0.00 <br />THIS RF-CE]IPT' $45.84 <br />BALANCE DUE <br /> <br />PAYEE: PACIFIC COAST ELEC'.,,;[NC:. ' : RECEIPT NOt 11776 <br />RECE[VED E{Y: JB <br /> ,_ ~ :' :, .';'~PE~,,C,K: CHECK ~¢: 2830 <br />~ THIS ~S A VALID PE~ZT ;* ~,I~ Z~E ~TE. ZF <br />~CTZ~ C~ FOR A P~ZOD OF !80 ~.: OR ,~:~i~ FA~ TO ~E~ ALL <br /> <br />REgRet SE~-~N ~800 P~IFI~ ~T <br /> <br />~O,M ,t Mc ,s-re ~v ~' OFFICE COPY <br /> <br /> <br />