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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO. 925 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> I am a registered builder OR ( ) the authorized representative <br /> of a registered builder. <br /> <br /> Other ..... <br /> <br />DATE: 04/17/82 TINE: 2:42.' 10p <br /> <br /> PHONE 588-5147 <br />'" CODE-A-PHONE 4:30 P.M. - 8:00 A.M. <br /> <br />OWNER; THOMPSON, DAVID T~XLOT: 56362~000 <br /> <br />9?325 <br /> <br />SE <br /> <br />SITUS ADDRESS; <br /> <br /> 8501 HOLMQUIST ROAD <br />AUMSVILLE OR <br /> <br />' CONTRACT cITY: <br /> <br />UGB; <br /> <br />:CATEGORY: R <br />iO¢CUPANCY: <br />i OCCUPAnT LOAD; <br /> <br /> !NO OF BEDROOMS: <br /> <br />MAH,JNG ADDRESS: i~g~D'vlsiON: <br /> <br />STAYTON, OREP_~DN 9?383 <br /> (~1~ pl.~ ~C~: ~TOWNSHiP: RANaE; ZONE: <br /> 3t 8S 1N AR <br /> <br />48 <br /> <br />TYPE: ELECTRICAL <br /> <br />CONTRACTOR, NO.. <br />LICENSE NO: <br />THONg, DAVID <br />PO BOX 192 <br />STAYTON, OREGON 9?983 <br />PHONE: NONE <br /> <br />PERMIT OR APPLICATION NO: 9001665 <br /> <br /> SUPERVISING ELECTRICIAN/NUMBER <br /> <br /> ITEM <br />MOBILE HOME SPACE (SVC EQUIP) <br />MOBILE HOME CONNECTION <br />FLEET SURCHARGE -ZONE 3 <br />ELECTRICAL STATE SURCHARGE <br /> <br />PAYEE: THOMPSON, DAVID <br />RECEIVED BY: dm <br /> <br />' * THIS IS NOT A PERMIT. THIS APP <br /> FOLLOWING D,fJST BE COMPLETED. <br /> ALL NECESSARY INFORICC, TION HA~ <br /> <br />QUANTITY AMOUNT <br />I $20.00 <br />1 $20_00 <br /> $3.84 <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />BALANCE DUE <br /> <br />$45.44, <br /> $0.00 <br />$45.44 <br /> <br />$0.00 <br /> <br />RECEIPT NO: 2154 <br />TYPE: OK CHECK ~: 1116 <br /> <br /> PROCESS I*EIERE THE <br />THE APPLICANT TO ASSURE THAT <br /> <br />PLAN REVIEW; BY <br />REI',4ARKS: <br /> <br />OFFICE COPY <br /> <br /> <br />