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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 /> <br />Other <br /> <br /> CONTRACT CITY'. <br /> <br />US~ ~F 8~ILDIN~: ENO OF BED~OOMi. ~ <br /> <br />PHONE: <br /> <br />SECTION; <br /> <br />T <br /> <br />TYPE.' ELECTRICAL <br /> <br />COl,[TRACTOR, NO,, <br />L:[I]IEIqSE <br />KOSfA, I EARl.. <br /> <br />PERMIT OR APPLICATION NOa 904&17~ <br /> <br /> SUFERVi,~,[NG .--..L,C'( ~,IC.(AN/NUMBE,t~ <br /> <br /> Z 'f E: W, <br />BkANCH ~IRE, U,I, [, ~.[I'ItOOT SE, k¥IC~:. 0~:~ FEEDER - tST C'tkLUIT <br />BRANCH CIRCU]:T,' W]:'T'HOUT SE:R'VlCIE OR I-[:,E,I)Ef EACH ADDITIONAL <br />EI...EC RZC~L STATE SURCHAR(;E <br /> <br />TOTAL ASSESSED f:'l_-':E~ <br />~ f~, ¥,,OU,'~ ( E. CF-I. <br />lbl],~ I ".CI::.],F l- <br /> <br />BALANCE DUE $0.00 <br /> <br /> PA¥C.E= K('IS'fA~ PEA~:-d... ¢2 REC~;ItPT NO~ 484!.3 <br /> RECEIVE'() :[W'J NB ~ TYPE: CK CHECK ~: 45~79 <br /> <br /> * THIS IS NOT A PERMIT. THIS ~PPLIDATIB~ ~ST GO THROUGH A R[VIE~ PROCESS WHERE THE <br />FOLLOWING MUST DE COMPLETED, IT IS THE RESPON~DIL[TY OF THE APPL~C~NT TO ~SSURE THAT <br />ALL NECESSARY ~NFO~AT~OH HAS ~EEN PROVIDED. <br /> <br />PLA!,t REV]:E:Q,', ,,,JY ............................... .gAls,, ....................................... C1,1Y JURIS,'DS:C'?ION',; ~tY ............................. DA, TE: ........................ <br /> <br />1;HA&kS: <br /> <br /> <br />