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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 /> <br />OWNER: ' ' ' <br /> .... /~:- v .... "-~';:',~" ')'"'~ '"' ' ~ <br /> * 7 ~ 'J 'qi'fF!!:~ ~ .... <br /> <br /> PHONE: ',? 6 9""7 r¢5 ;~ } ?ALUA'f ]'.ONu <br /> <br />TYPE: ELECTRICAL PERMIT OR APPLICATION NIl: 52I~9 <br /> <br />I,,K [ heft:, I EIF, ,~ btu ,, SEIF'ERV ]; S I h G ["~L_EC'[R i El ]; Ahi/NUH~d'.~R <br />L.~,¢,,,il ~ ,, <br /> <br /> gSSEf~iED FEES <br />PREV]:OU{~ RECEIPTS <br /> RECEIPT <br /> <br />t;!t.!Ai-4TI 'TY ~M()LINT <br /> <br /> 5 !i, :i 6 ,, '4~ <br /> $2,, 25 <br /> <br /> THIS IS ~ VALI~ PER~ZT * THIS P~RHIT EXPIRES 18~ ~Y~ ,FR~H ITS ISSUE D~TE, IF <br />CBNSTRUCT,O, CE~E~ FOR ~ PERIOD OF '18. DAYS. OR~F UO~S~R~;~ FALLS TO ~E~, ~LL <br />RE~UIREHENTS DF STATE LAWS AND M~RIOH COUNTY BUtL~IN6 ~N~-=---i OR~ZNANCES, THZS PERMIT <br />SH~LL DECOHE NULL AND VOID. <br /> <br />Df]!.4,41...:f) r;,. L:;:](:!'")'...I;[Y., MAFCi:Oi,i coul,4"rY ,, L ,I, ,,.:( ..1.= 0Ft::':~:i:;:1~¢41_ / bY <br /> <br />FORM # mC 1~-5~ REV. 4~0 OFFICE COPY <br /> <br /> <br />