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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO. 225 <br />220 HIGH STREET NE <br /> SALEM, C~REGON 97301 <br /> <br /> PHONE:588-5147 8:00- 4:30 <br />24 HOUR CODE,A-PHONE: 588-7904 <br /> <br />lamaregisteredbuilderOR( ) the authorized representative <br />Other <br /> <br /> ~ ..... ~' ' T L I <br />.... F].SHEE, F~:ILLIB ~ KA[EERINE ......................... 62.0_4;~=008 ................... .[~ ~ <br /> <br />: ' ~'~'f ~-~Tf¢ .......... O~D~; : / <br /> l~e 1138 112 ERIN ST -- i t ~ <br />i DETROIT OR ~7S42 L~ETEOIT ~YES i <br />,USE O¢ BUILQING: <br /> <br /> ........ ~ES~R~.ff~-T~ , <br />! 5e18 DANIEL ST S ~ <br />; SALEM ~7~6 WK 588-85~5 SITE NUNBE~: ?4-88578 <br />: PHONE: ~-8877 ~ VALUATION: <br /> <br /> '~ } ~OOK'. [S~OTION; TOWNSHIPT% ..... 7 Ri~eE'. ] ZONEi ........ l MAP: j <br /> <br />TYPE: ELECTRICAL <br /> <br />C0~TRACTOR, NO. 45933 <br />LICENSE NO: <br /> Pacific Coast Electric <br />PO Box 651 <br />S~ay~on~ 97383-0080 <br />PHONE: 769-7671 <br /> <br />PERHIT OR APPLICATION NO: 528~8 <br /> <br /> SUPERVISING ELECTRICIAN/NUMBER <br /> <br /> ITEM QUANTITY AMOUNT <br /> BRANCH CIRCUIT, WITHOUT SERVICE OR FEEDER ~ 18T CIRCUIT: 1 $35.08 <br /> BRANCH CIRCUIT, WITHOUT ~ERVICE OR FEE~ER ~ EACH::ADDITiONAL 1 $2.00 <br /> ELECTRICAL STATE SURCHARGE' : ' $1.85 <br /> <br /> PRE:¥IO28RECEIPT9 $8.88 <br /> : $~8.85 <br /> i i :,i ' ' <br /> BAE~N'CE $8.00 <br /> :~. <br /> PAYEE: Pacific Coast Electric inE RECEIPT,NO: 55257 <br /> RECEIVED BY: DM2 : CK CHECK e: 6920 <br /> <br /> * THIS IS A VALID PERHIT:*. [THIS.PERHI'~'EXP~RES:lS~ ~AYS :FROH ITS ISSUE DATE. IF <br />CONSTRUCT[aN CEASES FOR :A pERIOD FAILS TO HEET ALL <br />REGUIRENEHTS ~F STATE BRDINANCES, THIS PERNIT <br />SHALL BECOME NULL AND VOID. ' <br /> <br /> ~OIqAL~ E~ W~kEY~ MARtOH COU~'f¥ BUI¢~IN[ ~[[ici~C / i} .......................................................... <br /> <br />FO~M # MC 1~-~ REV, 4/8~ OFFICE COPY <br /> <br /> <br />