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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> P~tONE: 588-S147 8:00 - 4:S0 <br /> 24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am performing work on a groperty I own or occupy. <br />I am a rogistgred builder OR the authorized representative <br /> of a registered builder. <br />"file work will be performed by a registered builder. <br />Other. <br /> <br />I have read and agree to the terms stated on the reverse side of <br />this docdment, <br /> <br />~ HS/'[~ [;' E ;'HE,TARY SC;lOOt ~C~MMERC]:AL <br /> <br /> AJJHSVIt..LE OR 9%325 ;~UHSVII. LE NO ~ <br /> <br />DAME <br /> SITE NUNBE~: ?4-08?28 <br />PHONE: 74~.-.2872 VALUATION: <br /> <br /> BLOO~: $ECTION: ; TOWNSHIP: , RANGE: ~ ZONE'. MAP; <br /> <br />TYPE: ELECTRICAL PERHIT OR APPLICATIOH HO: ~4~78 <br /> <br />60I~TRACTOR,j NO, 28898 <br />LICENSE NO: <br /> Te(o The Electric Co <br />PO Box 67:1. <br />$¢lem, 97388.-.BeBe <br />POONE: 378-7747 <br /> <br />StJPERVISTN6 ELECTRICIAN/14UMBER <br /> <br /> tTEH QUANTITY AMOUNT <br />BI,ANOH CIl.~C,[J],l~ WIIHOLJI oEF, V'~C]~ OR FEEgER - iST CIRCUIT 1 $~5.88 <br />~RAF~CH ~IRCUIT, WITHOUT SERVICE OR F%E~ER EACH ADDITIONAL 1 ~,~.~8 <br />ELECT['¢ICAL STATE SiJRCHARGE $1.85 <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS REC_IF T <br /> <br />$~8.85 <br /> $0.00 <br />$38.85 <br /> <br />BALANCE DUE $0.00 <br /> <br /> PAYEE: Teco The Electric Co Irl¢ RECEIPT HO: ,.~6,,¢42 <br /> F~ECEIYE]O BY.- I)M2 TYPE: CK CHECK ~: 4881 <br /> * THIS IS A VALID PERHIT ~ THIS /ERHIT EXPIRES 188 DAYS FRQH ITS ISSUE DATE. IF <br />CONSTRUCTiOH CEASES FOR A PERIO~ OF 188 ~YS, UR IF COHSTRUCTIOH FAILS TO HEET ALL <br />R~DUIREHEHTS OF STATE LA~S AND HARIOH COUHTY BUIL~N& AH~ ZONING 0RD~HAHCES~ TH~S PERH~T <br />SHALL ~ECOHE HULL AHD VOID. <br /> <br />REMARKS:~'~ CII~/HAIR DRYER <br /> <br />DOHAI._D K. WOODI_,EY,~ MARION CGUNTY BUI. I. DING OFFICIAL / ~Y <br /> <br />.ORM # MC ~,S~ R~V, 4~o OFFICE COPY <br /> <br /> <br />