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SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am ~ registered builder OR ( ) the authorized rspdesentative <br />of e registered bul Per <br />The work will be performed by a registered builder, ! <br />Other .... I <br />I have read and agree 0 he arms safed on the revs se side <br /> <br /> 11~32 WARBLER LN NE ] ) ~ <br />~.SF§biL-~SR~r ....................... ~.-~-~ ~!~-2 ........... ~R~BN'"C-BUN~Y~*N8 .................... ~ ....... ,6. o~ '~o,oous. <br /> <br /> , ' ~--~k~---~k,;~ws ph--~- .................... <br /> 8778 CASCADE HWY NE ~ ~ - <br /> 8ILVERTON OR 97381 m ( SITE NUHBER: 94-B1925 <br /> PHO~[~ ~3~[~7 ~ ~ ~_ ~J~U k[[_~ .......................................................... <br /> ............ I'~ ...... ~ i ~ ....... T~"~''/~°'* ]~*'" <br /> <br />TYPE: ELECTRICAL <br /> <br /> CONTRACTOR~ NO. <br /> LICENSE biO= <br /> GRAY~ WILL <br />8778 CASCADE HWY.NE <br />SZLVERTON OR 97381 : <br />PHONE: 873-7157 <br /> <br /> Il'EM <br />MANUFACTURED'HOME <br />ELECTRICAL STATE <br /> <br />PAYEE: Herbert C <br />'RECEIVED BY: MB <br /> <br /> ~ THIS IS HOT A <br />FOLLOWING MUST BE <br />ALL NECESSARY <br /> <br />PLAN REVIEW: <br /> <br />REMARKS: MS SERVICE <br /> <br />PERMIT OR;APPLICATION NO: 9aS586B <br /> SUPERVISING ELECTRICIAN/NUMBER <br /> <br /> QUANTITY AMOUNT <br /> 1 $40.0~ <br /> $2.08 <br /> <br /> $42.~0 <br /> $0.00 <br /> <br /> $0.00 <br /> <br /> RECEIPT NO: 57535 <br /> CK CHECK ~: 3551 <br /> <br /> REVIEW PROCESS WHERE THE <br />THE APPLICAHT TO ASSURE THAT <br /> <br /> BY ............ DATE ........................ <br /> <br />FORM # MC 15-56 ME¥. ~ OFFICE COPY <br /> <br /> <br />