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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 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> I am performing work on a property i own or ocoupy.~ <br /> <br /> Other <br /> <br /> DATE: 08/05/~2 TIHE: 8:00:i5 <br /> WINDINGES BROTHERS ' RESIOENTIAL <br /> <br /> 17876 BUTTE¥ILLE BOAO NE ' <br />USE O~ BOILDING; : NO: ~¢ BEDROOMS: <br /> <br />PHONE: 981-5422 <br /> <br />SITE NUMBER: 92-02854 <br />VALUATION: <br /> <br />TYPE: ELECTRICAL PERMIT OR APPLICATION NO: ~04171~ <br /> <br />CONTRACTOR, NO. 0~281 <br />LICENSE NO: <br />William K Engelman <br />PO Box 451 <br />Hubbard. 97052-0000 <br />PHONE: 981-8041 <br /> <br />SUPERVISING ELECT~ <br /> <br /> ITEM <br />MANUFACTUREB HOME SERVICE/FEEDER <br />ELECTRICAL STATE SURCHARBE <br /> <br />AMOUNT <br /> SeO.O0 <br /> $4.00 <br /> <br />TOTAL ASSESSEO FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />$84.00 <br /> $0,,00 <br /> $0.00 <br /> <br /> ~ BALANCE DUE $84.00 <br />PAYEE: ~ ../ RECEIPT NO: <br /> <br />· THIS IS NOT A PERHIT. THIS APPLICATION HUST GO THROUGH A REVIEW PROCESS WHERE THE <br />FOLLOWING MUST BE COMPLETED. IT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT <br />ALL NECESSARY INFORMATION HAS BEEN PROVIOEO. <br /> <br />PLAN REVIEW: BY .......... DATE ............. CITY JURISDICTION: BY ........ DATE ............... <br /> <br />REMARKS: 2 MOBILE HOME SERVICES <br /> <br />OFFICE COPY <br /> <br /> <br />