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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 /> of a registered builder, DATE <br />( ,/'~'/ The work wilt be performed by a registered builder. <br />! ~.} Other , <br /> I have read and agree to the terms stated on the reverse side of : <br /> <br />TYPE= ELEICTRtCAL <br /> <br />CARL F,, <br /> <br />~l OJ ..... <br /> <br />SL?,':'ERV~: f¢I NI; EL E¢'TR ]:C t AN/NUi~:81E F( <br /> <br /> · ~d.,,I ....0,,I,,,~,,,,v CA~;,~,,,.,: ~ f,,_(.,,_.l.i' ~ NO,, <br /> <br />F"OLL¢W~N~ MUST BE COMPLETED:, ~T IS THE RESPONS!B~E~TY: OF THE APPLICANT T0 ASSI[]~E THaT <br /> <br />,C]:TY JIIRZS:O;[CT:;;f]N." ~.Y :OA <br /> <br />FO~ ~ u¢t ~.~6 R~v, 4,,ee OFFICE COPY <br /> <br /> <br />