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MARION COUNTY BUILDING INSPECTION <br />SEN-ATORBLDG NO 225 <br />220 HIG~ ~RTREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588~5147 8:00 - 4::30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />of 8 registered builder, <br /> <br />Other__ <br /> <br />SIGNATURE OF APPLICANT <br /> <br /> TAX LOT <br /> <br />· .I'4ARt6~N COUN1Y , NO <br /> <br /> 4?24 5HAW HIGHWAY SE <br />AUfff~ViLLE OR 9?325 <br /> <br />CATEGORY <br /> <br />Sllg NOIr]DER; 13267 <br />VALUA ~ ION: <br /> <br /> NO NO <br /> <br />fYPE: ELECFRICAC <br /> <br />CON TRACIOR, NO. 6281 <br />LICENSE NO; <br />ENG~Lt4AN EL6CIRiC <br />P.O. ~O× 453 <br />HUBBARD, OREGON 97032 <br />PHONE~ 98~-8041 <br /> <br />PERf4IF OR APPLiCAtiON NO: 329~0 <br /> <br /> ,SUPERViSiNG ELEC'I'RIC~AN/N~I~SER <br /> <br /> IIEM <br />5ERViCE/FEEO~R 101 rD ~00 ~¢flPS <br />ELECIRICAL 51A~E SURCHARGE <br /> <br />QUANIlIY ACC~JUN~ <br /> 1 $60.00 <br /> $3_00 <br /> <br />PREViOtJ$ RECEIPTS <br />THIS RB.~Ei P f <br /> <br />$63.00 <br /> $o.oo <br />$~,oo <br /> <br />BALANCE DOE $0.00 <br /> <br />RECEI P'r NO: 34?34 <br /> <br /> RECEIVED BY: DM2 ................................................................ IYPE*. CK CHECK g: 1189 <br /> <br />~ THI~ IS A VALID PEtiT * THiS P~IT ~IR~ 180 ~ ~ ITS I~E ~TE. iF <br />~ST~CTI~ C~ FOR A PERIOD OF 180 ~, OR I~ ~T~CTI~ ¢AI~ TO ~EET ALL <br />~1~T8 OF STATE ~ ~D ~RI~ ~N~ 8UI~ING ~O Z~IN60RDI~. THIS PE~IT <br />~ALL B~E NULL ~D <br /> <br />REMARKS: SERVIC~ ONLY FOR iRR PUMP R~7'~35 ~ <br />DONALD ~. ~E)ODLEY, IAARiON COUNTY 8UiLOING OFFiCiAL / BY ............................ ~ <br /> <br />OFFICE COPY <br /> <br /> <br />