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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: 5~-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> i VALUATION= <br />...................~o~: ~dc~ ................. ~§~'~ '~' ............ ~'~:' ................ l~' .............. I~ ........ , <br /> <br />TYPE= ELECTRICAL <br /> <br />CONTRACTOR[ NO. 8276~ <br />LICENSE <br />~chae[ A Mod~ne <br />Y35 Ven~ura Ave N <br /> <br />PHONE~ <br /> <br /> ITEH <br />~RANCH CIRCUIT. WITHOUT ~ERVICE OR FEEDER - IST CIRCUIT <br />ELECTRICAL STATE SURCHARGE <br /> <br /> TOTAL ASSESSED:FEES <br /> PREVIOUS RECEIPTS <br /> THIS:REC'~EIPT <br /> <br /> . -.BALhNCE DUE <br />PAYEE= H~chaeI A ~odi~e <br />RECEIVE9 ~Y: DM2 "TYPE= <br /> <br />PERNIT OR APPLICATION NO: 4842~ <br /> <br /> ~UPERVISiNG ELECTRICIAfl/NUHBER <br /> <br />QUANTITY AMOUNT <br /> I $35.00 <br /> $1.75 <br /> <br />$8.~B <br /> <br />$0.80 <br /> <br />RECEIPT NO= 58728 <br />CK CHECK ~: 25~8 <br /> <br /> $ THIS I8 A VALID PERHIT ~ THlS-PERH!T'EXPII~.181 DAYS FROH IT~ ISSUE DATE, IF <br />COHSTRU~TIOH CEASES FOR, A'PERIOD' QF;1,,8t~_.DAY~"OR IF~,~STt~UCTION FAIL~ TO HEET ALL <br />REdIReCT5 OF STATE LA~ ~ H~I~"~TY ~UIL~I~ AHD Z~iN& OR~IHA~ES~ THIS PERNIT <br />SHALL BECOHE HULL AND VOZP" <br /> <br />REMARKS: 1 <br /> <br />OONALg E. WOOOLEY, HARION COUNTY BUILDING OFFICIAL / BY <br /> <br />FORM # MC 1&56 R~-V. 4/~0 OFFICE COPY <br /> <br /> <br />