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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 />The work will be performed by a regisferod builder, <br />Other_ <br /> <br />I have read and asree to the terms 8tared on the reverse side of <br />this document, <br /> <br /> .......... +&¥ '[bT; <br />TI;ME: 1,,'5: 03: 4:[ <br /> <br /> I:[6'56 FALC, ON (;T ..... <br />AURORA OR 97_00.~ <br /> <br /> ........ CATEGORY. <br /> <br />NA]:~ON. COUNTY!, NO ................. ' <br /> <br />MAJL~JNG <br /> <br />SU BOIVIStON. <br /> <br /> 20 WALKIN6 WOOD DR <br /> LAKE OSWE,gO., OR 97005 <br /> PHONE: 636--7918 <br />LOT'. , BLOC K~ SECTION TOW NSH IP'. <br /> <br />CEN'f'RUR¥ MEADOWS <br /> <br />SITE NUNBER: 93-88998 <br />VALUATION: <br /> RANGE: <br /> <br />HS ................. f,lO ........ <br /> <br />TYPE; ELECTRICAL PERMIT OR APPLICATION NiO: 9~45946 <br /> <br />COt! fI-.,,A, LTOR,~ NP,, <br />L.I[,EN.SF <br /> PARKIN ELECTRIC THE <br />20250 .~; NOLALLA AVE <br />OREGON C I I'Y¢, 9'7¢45 <br />PHONE: <br /> <br />SUF'EF(¥1SINGELECI R,[CIAN/NUNBLk" .... ' "" <br /> <br /> T'fEN <br />MANO:'ACTURED I-lONE oERVICE/I: F.~EDE, R <br />ELECTRICAL STATE: SURCHARGE <br /> <br />QUANT I TY A~iOtjNIy <br /> 1 $40,, <br /> $2.90 <br /> <br /> 'rOTOr,, A~SE.~SED F'EES $42.00 <br /> PRE~ IOUS REC~IPT~" $0.00 <br /> TNIS RECEIPT $42.,~ <br /> <br /> ~At,_AII{.,E DUE $~. 8~t <br /> PAYEE: PARKIN ELECTRIC ];I,[C RECEIPT t,10: 48158 <br /> RECE,[vED BY: PM ................................................................... TYPE: CK CHECK 4~: 1474 <br /> * TH~S ~S NOT A PERH~T, THIS APPLICATION MOST GO THROUGH A REVIEW PROCESS WHERE THE <br />FOLLOWZH~ ~UST BE CQHPLETEB. IT IS: THE EESPONSIBILiTY OF THE APPLICANT TO ASSURE THAT <br />ALL NECESSARY INFORMATION HAS BEEN PEOV~ES. <br /> <br />F'LAN REVIEY". BY ............................ DATE ........................ <br />RENARKS: NH SEI-,V,[CE <br /> <br />CITY JOI~ISDICT]:ON: BY .............................. DATE ........................... <br /> <br />FORM # MC 1 ~-,~ REC. 4/~0 O F F ;C E COPY <br /> <br /> <br />