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MARION COUNTY BUILDING INSPECTION <br />COMMUNIlnf DEVELOPMENT CENTER <br /> <br /> 285 Church Street NE * Room 132 · Salem, Oregon 97301-3670 <br />office Hours: 8;00-4:30 * Phone: (503) 588-5147 o 24-HR Inspection Line: (503) 588-7904 <br /> <br /> ELECTR[CAL AF PLICATIOH <br />DATE/TIff[ : t1/~9/95 I4:42 ACTIVITY HO = 95-17513 <br />TYPE = CoemerciaI addition/aIteratto~ STATUS APPLIE~ <br />OCCUPANCY = D-2 APPLIED <br /> <br />~ORK <br /> <br />S:I: TE ADDRESS <br /> <br />CR )So STREET <br /> <br />PARCEL NL;H~ER <br />OWNER NAME <br /> <br />: 11~61MII. L. CREEK RD SE AM <br /> <br />: HWY 22 E <br /> <br />: STAYTON FORD <br /> <br />APPLICANT <br />NAME : STAYTON FORD <br />ADDRESS : P 0 BOX 377 <br /> MILl_ CITYo O~ <br /> TRISNA WESTE HOUSE <br />PHONE : 769-66~ <br /> <br />COIqTRACTOR :MCCALL LELAND <br />PHONE : 769=5301 <br /> <br />EL.ECTRICIAH <br /> PHONE <br /> <br />PHONE : <br /> <br />Unl~_,D~,scrip~io~ ....... <br />-~1 ~ignal circuits <br />i 8~a~e surcl~arge <br />I Refund <br /> <br />~7368 <br /> <br />95-'17512 <br /> <br /> CITY~ MAR:£ON COON'TV <br /> <br /> OCCB: 49734 <br /> <br />COHIRACTOE LICENSE: <br />SUPIRVISOR LICENSE: <br /> <br />Assessed ~ees . 4~.00 <br />AdjQs~Me~tS : <br />Total fees : 4~.00 <br />Total paX~eDts: 4=.80 <br />PAYEE: STAY'TON FORD Bal&nce ~ue : ,88 · <br /> <br />THIS 18 HOT A P£RHIT. iT IS THE RESPONSIBILITY OF THE APPLICAHT TO ASSURE THAT <br />ALL HECESSARY INFORHATIOH IS PEO¥I~E~ AN~FEES P~I~ ~EFORE A PE~IT HAY ~E I~SOED. <br /> / <br />SIGNATURE OF APPLICANT: ................. <br /> / <br /> <br />********************************************************************************* <br />DONAI, D E,, WOODL, EY~ MARION COUNTY BUILDING O~FICIAL BY CLYNCN <br />...................................... FOE OFFICE USE ONLY ................................ <br /> HAP: ~(~NF= PROFERTYJ L. OCATOR: <br /> PLAN REV{E.W, DA]'Bi: ZONING REVIEW: DALE,, <br /> <br /> <br />