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MARION COUNTY BUILDING INSPECTION <br />SENATOR OLDG, NO, 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 8;00 - 4:30 ~ <br /> 24 HOUR CODE~A-PHONE: S88-7904 ~ / //¢ ~ <br /> <br /> ,am performingwor, on8 property , own or o¢¢upy. A~ ~~~ <br /> I~,_ ,~,~,~,-~- -~=,-~*'~e~u?l~'~er OR ( )the authorized representative SIGNATURE OF APPLIC · <br /> <br /> The work wi{I be performed by a registered builder, ' <br /> <br /> I have read and agree to the terms sta~ed on the reverse side o¢ ~ DA~E: ~ <br /> this document, <br /> ' ~A~E: ie/04/9~ TIME: 12:56:22 <br />~OW~E~: FORREST BOWHAN PROPERTY NOT ; ~k LOT. ~EIqTI~L' <br /> <br />PHONE: <br /> <br />SITE NUHBER: 93-93418 <br />VALUATION: <br /> <br />[,o'r~ ,8LOOK: SECTION: ' .... ! fbWi~'wi~; ......... ......... ,~6~'~i ..........i ~,~' <br />[ : , <br /> <br />i I i'"~' ~OT: <br /> <br />TYPE: ELECTRICAL <br /> <br />CONTRACTOR~ NO. 48560 <br />LICENSE NO: <br /> Sparky Electric <br />7537 Lakesioe vr NE <br />~alem, 9730~-0~00 <br /> <br />PERNIT OR APPLICATION NO: 503~Z <br /> <br /> SUPERVISING ELECTRICIAN/NUMBER <br /> <br /> ITEM <br />RECONNECT ONLY <br />ELECTRICAL STATE SURCHARGE <br /> <br />QUANTITY AMOUNT <br /> 1 $40.00 <br /> $2.00 <br /> <br /> TOTAL ASSESSED FEES $42.00 <br /> PREVIOUS RECEIPTS $0.00 <br /> THIS RECEIPT $42~00 <br /> <br /> BALANCE DUE <br /> PAYEE: Spar? Electric Inc RECEIPT 1,10~ 52782 <br /> RECEIVED BY. PM TYPE: CE CHECK ~: 1~51 <br /> ~ THIS IS A VALI~ PEENIT Z THIS PEEN~T EXPIRES 28~ ~AYS FROM ITS [SSUE 9ATE. IF <br />COHSTRUCT~0N CEASES FOR A PERiO~ OF &S~ DRYS, OR IF CONSTRUCTION FAILS TO NEET ALL <br />REOUIREMEHTS OF STATE LA~S AND HARION COUNTY BUILDING AND ZONING ORDIHAHCES~ THIS PERMIT <br />SHALL BECOME NULL AND VOID. <br /> <br />REMARKS: RECONHECT AFTER FIRE <br /> <br />DONALD E,, WOODLEY, MARION COUNTY BUILDING OFFICIAL / BY <br /> <br />FOn~, ~¢ *~-~ ~V, ~o OFFICE COPY <br /> <br /> <br />