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FRQ~ TUALATINEI.-ECTR~C ~82 790~ <br /> <br />M. AR~ON COTJNI~' BUXLDL~G INSPECTION <br />COMMUNITY DEVELOPM£~T CENTER <br />285 Church St NE - R~m 132 <br /> Satem. OR 97301 <br /> <br /> 24 Hr Inq~s~tion Line: <br /> O~$~e: ~88-514'/ 8:00,.m. - 4:30 <br /> <br />P/ease complete all Sectione, 1 ~rough $ <br /> <br />L LOCATION OP INSTALLATION <br />,~,~a,~..14342 Stenbock ~Y NH u~i'l: '101 ~:102' <br /> <br />ARE NON-TRAN$1qLq.'UM~ ~ l~g~al,R~ IF WOrK la H~ <br />~ ~ 1~ ~Y$ OF ISSUAN~ OR ~ <br /> WO~ IS SUS~ FOR I~ DAYS, <br /> <br />3. PI~.N ~.h-Vl~ ~CTION <br /> <br /> Madon CoUnty does not require a plan review. <br /> We will provide plan review ~etvke if yOu Complete <br /> SecQon 5B and submit two (2) s~s of plans and <br /> sp~cificatiotu with this application. <br /> <br />M~ l$-.~ 1 <br /> <br />PERMIT NO: <br /> <br />Date: <br /> <br />Issued by: <br /> <br /> The fen foe hem~h eia.=uit a wltheat <br /> <br />Fu.'~ branch cJr, uit <br />~ach a~d b~h <br /> <br />$40~0 _ 2 <br />S~O.O0 2 <br /> <br />$35.00 <br />$ 2.00 <br /> <br />S~O~O Z <br /> <br />AL ~nmr ~,~al o f f~ rm,-n S~. P.4.. <br /> <br />S. int~'~ of Iie~ Al Ibf plea <br /> <br />C. Investi~lto~ I%o (ift'e,4ulot~d) <br /> <br />Subt~.al <br /> <br />TOTAL AMO~ DU~ <br /> <br /> <br />