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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 />( I am 3 re~g,i~terad builder O~, ( ) the authorized representative SIGNATURE OF AP~UCANTI <br /> of a regJ~tereS builder. / .. <br /> <br /> KADERLIK, MARVEL:, <br />SITUS ADDRESS: <br /> <br />CATEGORY: <br /> RESIDENTIAL <br /> <br /> 1020: MASH INGTON <br />AUMSVI LLE OR 97325 <br /> <br />USE OF BUILDINg: <br /> <br />.~tlJIv~V] LLE 97825 , <br />PHONE: 749~2161 SITE NU~ER: 7553 <br /> <br />NO NO <br /> <br />TYPE: :ELECTRICAL <br /> <br />CONTRACTOR, NO. <br />LICENSE NO: <br />KADERLIK, <br />PO 8OX 829 <br />AUN~VI LLE g7325 <br />PHONE: 749-2'161 <br /> <br />PEF~IT O~ APPLICATION NO: 17285 <br /> <br /> ,~.~.~.~.~.~.~.~.~U P E RV I S I N G ELECTRICIAN/NUMBER <br /> <br /> ITEM <br />C/r 'sEEr ,101~200 <br />FLEET SURCHARGE -ZONE <br />,E~TRIC, AL STATE EAJRCHARGE ~. <br /> <br />QUANT ITY <br /> 1 <br /> <br />OONALD E. NOODLEY, NARION COUNTY BUILDING OFFICIAL /,bY <br /> <br />FEE~' <br /> <br />AJ*~UNT <br /> $70.00 <br /> $3.84 <br /> $~. 5o <br /> <br /> · $? 7.34 <br /> $o. OD <br /> $77.34 <br /> <br /> $o. oo <br /> <br />TO I~ET AL-L. <br /> ,. THIS PER~IT <br /> <br /> OFF~CE COPY <br />FORM#MC~5-58 RgV H/Sa <br /> <br /> <br />