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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 /> ELECTRICAL PI~IT <br />DATE/TINE : 86/38/97 18:19 P~RNZT NO t 97-04914 <br /> <br />OCCUPA~Y = R-3 I~ <br /> <br />WORK DESC : PD FOR 4~AMP SVC~(2 2~AMP FEE~ERS~3~ CIR 96-59~3 <br /> <br />S~TE ADDRESS : CITY~ MARION COUNTY <br /> 7588 ALBUS RD ~E AM <br /> <br />APPLICANT <br /> NAME <br /> ADDRESS <br /> <br />PHONE <br /> <br />SUPV ELEC <br />PHONE <br /> <br />CROSS STREET : LEVERMAN RD <br /> <br />PARCEL NUMBER : 56512-888 <br /> <br />OWNER NAME : ETZEL,LEROY A & JANINE MARIE <br /> <br /> : PACIFIC COAST ELECTRIC <br /> : 1425 E. BANTIAM STREET <br /> <br /> STAYTON, OR 97585 <br /> : 769-7671 <br /> <br />CONTRACTOR : PACIFIC COAST ELECTRIC INC OCCB: 8845933 <br /> PHONE : 769-7671 <br /> <br />ELECTRICIAN : PACIFIC COAST ELECTRIC INC CONTRACTOR LICENSE: 24-172C <br /> PHONE : 769-7671 <br /> <br /> : GILLETTE ROBIN ALLEN SUPERVISOR LICENSE: <br /> ~ GILLETTE ROBIH ALLEN <br /> <br /> Uoits Bescriptiop . Fee <br /> Service/feeders up to 288 amps 1~0.00 <br /> ~ Service feeders, 281-400 amps 60.00 <br /> 38 Branch circuits 68.00 <br /> I State surcharge 11.80 <br /> 1 Refund .00 <br /> <br /> Assessed fees : 231.88 <br /> AdjustMents : <br /> TotaI fees : 231.88 <br />PAYEE~ PACIFIC COAST ELECTRIC IHt Total paxMents: <br /> Balance due : .88 <br /> <br />THIS PERHIT IS HON-TRANSFERADLE AMD EXPIRES 188 DAYS FRGN ISSUE DATE IF WORK HAS <br />NOT COMMENCED, OR IF CONSTRUCTION CEASES FOR A PE~IOI~ OF 188 DAYS, ~ IF ~RK <br />FAILS TO ~ET ALL REQUIREMENTS ~ STATE LAMS AND H~IOH COUNTY ~I~HCES. UPON <br />~RITTEH RE.ST, ~E SIX H~TH EXTENSION HAY ~ ~T~. <br />SIGNATURE OF APPLICAHT= ............................................ <br /> <br />PONDAID E WOODLEY~ HARIOH COUNTY 9UILDIN~G OFFICIAL / BY CLYNCH <br /> <br /> <br />