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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> "PHONE 588-5147 <br /> CODE-A-PHONE 4:30 P. Iv~7- 8:00 A,M. <br /> <br />of a registered buflder, <br /> <br /> I have read and agree to the terms stated on the reverse side <br /> <br /> DATE: 07/29/88 TIME: 3:42:50p <br /> <br />OWNER; <br /> HENSLEY, MARIE <br /> <br />S~TUS ADDRESS: <br /> <br />CONsTRUCT[ON TYPE: OCCUPANCY: <br /> <br />RESIDENTIAL <br /> <br /> AURORA OR 97002 <br /> <br />MAIL. lNG ADDRESS: [ ~UBDIVISION; <br /> SUNSET' <br /> MOBILE <br /> PARK <br /> 17585 LANDURA CT NE <br /> AURORA OR 97002 <br /> PHONE: 982-4604 ! SITE NUMBER= 4.986 <br /> I VALUATION: <br /> <br />W,DTH; 7o 7000.00,, SF <br /> <br />TYPE: ELECTRICAL <br /> <br />CONTRACTOR: NO. <br />LICENSE NO. <br />HENSLEY, MARIE <br />17585 LANDURA CT NE <br />AURORA OR 97002 <br />PHONE~ 982-4604 <br /> <br />PERMIT OR APPLICATION NO: 9009995 <br /> <br /> SUPERVISING ELECTRICIAN/NUMBER <br /> <br /> ITEM <br />MOBILE HONE SPACE (SVC E(~JIP) <br />MOBILE HONE CONNECTION <br />FLEET SURCHARGE -ZONE 6 <br />ELECTRICAL STATE SURCHARGE <br /> <br />QUANTITY AMOUNT <br />1 $20.00 <br />1 $20.00 <br /> $7.68 <br /> 2.00 <br /> <br /> ]'TdYAL:A'-S~ED FEES $49.68 <br /> PREVIOUS RECEIPTS $0.00 <br /> THISRECEIPT $4.9.68 <br />' ':i::BAL~cE DUE $0+ 00 <br /> <br />PAYEE; HENSLEY, MARIE ,/~"~- RECEIPT NO: 10621 <br />RECEIVED BY: P8 ,~ , TYPE: CK CHECK ~: 2333 <br /> <br />FOL~ZNG ~ST BE ~PL~ED. ~ [T; Z8 ~E ~S[B[E[~ OF ~E APPLZ~T TO ~RE ~T <br />ALL N~ IN~TI~ H~::B~ ,P~IDED, <br /> <br />PL~ REVIEW: BY DATE~_~ CI~ JURISDICTION: BY DATE <br />R~R~: SE~/~NN ~4152 <br /> <br />~O~M. MC ~5-~6 R~,~ ~/~ OFFICE COPY <br /> <br /> <br />