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MARION COUNTY BUILDING INSPECTION <br /> <br /> 3150 Lancaster Dr. N.E. · Suite C · Salem, Oregon 97305-1398 <br />Office Hours: 8:00-4:30 · Phone: (503) 588-5147 · 24-HR Inspection Line: (503) 373-4427 <br /> <br /> ELECTRICN.. PERfllT ~r <br />D~TE*q'ZHE ~ ~6/S2/97 :11~2S P~H[T ~ ~ 97-~2a <br />TY~E ........ ~-~i~nt. addition/alteration STATUS = I~D <br />~C~Y ~ R-3 I~ z ~/~2/1997 <br /> TO EXP[~ ~ 11/29/1~7 <br /> <br />WORK DESC ~ CIR FOR HP <br /> <br />SITE A~DRFSS : <br /> 12~55 MEAL ST SE AM <br /> <br />CITY: MARION COUNTY <br /> <br />CROSS STREET : STAYTON MARION RD <br />PARCEl. N!JMBER : <br /> <br /> OWNER NAME <br /> <br /> APPLICANT <br /> NAME <br /> ADDRESS <br /> <br /> PHONE <br /> <br />CONTRACTOR <br />PHONE <br /> <br />El FCTRICIAN <br /> PHONE <br /> <br />SIIPV EIEC <br />PHONE <br /> <br />: HOLLINGSWORTH,ALTA & ROBERT <br /> <br />: PACIFIC COAST ELECTRIC INC <br />: 1425 E. SANTIAM STREET <br /> <br /> STAYTON~ OR 97383 <br />: 769-7671 <br /> <br />: PACIFIC COAST ELECTRIC INC <br />: 769-7671 <br /> <br />: PACIFIC COAST ELECTRIC <br />: 769-7671 <br /> <br />: ~ILL. ETTF ROBIN ALLEN <br />: gILLETTE RODIN ALLEN <br /> <br /> OCCB: 0045933 <br />CONTRACTOR LICENSE: 24-172C <br />SI!PERVIS~R LICENSE: 3653S <br /> <br /> Branch circuits 35.0~ <br /> State surcharge 1.75 <br />1 Refund .00 <br /> <br /> Assessed fees : 36.75 <br /> Adjustments <br /> Total fees <br /> 36.75 <br />PAYEE: PACIFIC COAST ELECTRIC INC Total paxnents: 36.75 <br /> Balance ~ue : .00 <br /> <br />THIS PER. HIT IS NON-TRAIqSFERASLE ~ EXPIRES 1SS ~YS F~ I~ ~ATE IF ~RK HAS <br />~T:C~CED~ ~ IF C~T~TI~ C~ES F~ A ~IOD ~ 1~ <br />FAJLS TO ~T ~L RE~IREH~S ~ S..,TE L~S ~ ~R~ C~TY ~DIH~ES. U~N <br />~[~EH ~STv ~E SIX H~TH E~HSI~ HAY ~ <br />SIGNATURE OF APPL~CAHT: <br /> <br />~ON~AI~ E WOOZILY, HARMON COUNTY BU~LDINB~ OFFICIAL / BY H~ULL <br /> <br /> <br />