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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. 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: 588-7904 <br /> <br />I am a registered builder OR ) the authorized representative <br />of a registered builder, <br /> <br />this document. <br /> <br /> :'" ' ' TT .... ~":'. ' <br /> DC~IL. OBfS?/?;~ ~{E... 18,, ~.,~. ]-8 ............................................................. ~¢~6~'21 ............... <br />~OWNER; ~ TAX LOT'. <br /> MA~CHKE~ LES & BETTY 70551-261 RESIDENTIAL <br /> <br /> 11&85 LARK CT NE F~E&TffXEYE-i~T7 i'"O'~i CEO'O~AM¢~{8~Bi <br /> AURORA OR 97882 ~ MARION COUNTY NO <br /> <br /> 2201 N ~ENZZES 9R ~ <br /> PQRTLAbID,, OR ~7217 MOBILE 799-1158 ~ SITE NUMBER: ~3-~2655 <br /> PNONE: ~8~-6~62 ~ VALUATION: <br /> <br />..... ;~z ~ [__.~~ ....... ~.s ................ ~...~ .................. ~.__~ .................... 1._~ <br /> WSDTH; ~DE~ ~AREA iUNT~ ~ RR~G. LOT; CORNER; <br /> <br />TYPE: ELECTRICAL PERHZT OE APPLICA~[ON: NO: 48844 <br /> <br />CONTRACTOR, NO. 50829 <br />LICENSE NO: <br />J R Electric <br />PO Box 26~ <br />Hubbard. ~70~2.-B000 <br />PHONE: ~81-~713 <br /> <br />SUPERVISING ELECTRICIAN/NUMBER <br /> <br /> ITEM <br />MANUFACTURED HO~E SERV];CE/FEEDER <br />BRANCH CIRCUIT~ WITH:SERVICE OR FEE~ER <br />ELECTRICAL STATE SURCHARGE <br /> <br />QUANTITY AMOUNT <br />I $40.00 <br />1 $2~00 <br /> $2.10 <br /> <br />PLAN REVIEW: BY ~j DATE :~:~L~: ;: CIT:Y, JURISDICTION: BY _- DATE <br /> ............. ' ~F-"U '"-'-'~ ":, ............................................ <br />REMARKS: H8 8ER /1 needs elco. si,q~iature o1'~ ~ile) <br /> <br />FORM # MC 15-56 REV. 4/90 OFFICE COPY <br /> <br /> <br />