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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-PRONE: 588-?904 <br /> <br />I am a registered builder OR ( ) the ~uthorized representative SIGNATURE OF APPLICANT: <br />The work will be performed by a registered builder. <br /> <br /> l co.sTSCCT ON t AL <br />].1658 WARPLER ,LN i <br /> <br /> 10205 SE SLJNNYS1DE RI) <br /> PORTLAND ? 97815 I SITE NUMBER~ 94-81977 <br /> PHONE: 6~2."'2260 , ~ VALUATION: <br /> <br />TYPE: ELECTRICAL PERHIT OR APPLICATION HO: <br /> <br />CONfR~CTOR, NO,, <br />LICENSE NO: <br /> HENKE9 ELECTRIC <br />P.O. BOX 889 <br />WOO~BU~N, 97071 <br />PHONE: 981-7022 <br /> <br />82042 <br /> <br />,SUPERVISING ELECTRICIAN/NUMBER <br /> <br />MANUFACTURED HOME EEl)ER <br />ELECTRICAL STATE SURCH~RC : <br /> <br /> PAYEE: HEMKE8 ELECTRI~ii <br /> <br /> * THIS IS A VALID <br />CONSTRUCTION CEASES <br />REQUIREMENTS OF STATE <br />SHALL SECOHE NULL AND <br /> <br />QUANTITY AMOUNT <br /> :L <br /> S2.~0 <br /> <br />$4~,00 <br /> $0.00 <br />$42.00 <br /> <br />$8.00 <br /> <br />RECEIPT NO: 58882 <br />BE:i:: CK CHECK ~: 7570 <br /> <br /> ISSUE DATE. IF <br />ILS TS HEET ALL <br />ORDINANCES, THIS PERMIT <br /> <br />D[IMALD $. WOODLEY, <br /> <br />¢or~ ~t fac ~s-~ n~v. 4~ OF FICE COPY <br /> <br /> <br />