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MARION COUNTY BUILDING INSPECTION <br /> <br /> 3150 Lancaster Dr. N,E. · Suite C * Salem, Oregon 97305-1398 <br />Off~eHour~: 8:00.4:30 · Phorm: (503) 585-5147 · 24-HR Indirection Une: (503) 373-4427 <br /> <br />CROSS STRFFT <br />PARC[I. <br /> <br />OWNFR NAMF <br /> <br />APPI.TCANT <br /> NAMF <br /> A~OR:S~ <br /> <br /> PHONE <br /> <br />C~NTRACTO~ <br />PHONE <br /> <br />FLFCTRIC~AN <br /> PHONE <br /> <br />SHPV FtFC <br />PHONE <br /> <br />: END OF TOWN NFXT TO COUNTY BLDG WEST SIDE <br />: 57704-gG0 <br /> <br />CITY OF A[IM,~VTLLF <br /> <br />97~S~ <br /> <br /> OCCB: B~§~67 <br />CONTRACTOR LICENSE: 24-147C <br />S[IPFRVISOR LICENSE: 272~S <br /> <br />t Temp serv/f~eds up to ;~0 amps ~5.00 <br />] St~e surcharge 1.75 <br />I Re,fu~d .OG <br /> <br /> Assessed fees 36.75 <br /> Adjustments .00 <br /> To~l fees 36.75 <br />PAYEE: RRAWF~RO W'[I,.I.TAN T Total payments: 36.75 <br /> I~la]ance due : .~0 <br /> <br />THIS PERMIT IS HON-~ER~L£' N4~ EXP[RES ]B~ D~YS FROM I~ DA~ IF U~K <br /> ~[ R ~;~ ~5 FOR A P~[~ ~ ~ ~Y5. ~ ~F ~K <br />S~NATIIRF OF APPi [CANT: <br /> <br />DnNPA[~ E W~ODLEY. HAR~ON COUNTY BII~i.D~HRG OFFICIAL / ~y TTOHEY <br /> <br /> <br />