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MARION COUNTY BUILDING INSPECTION <br />SENATOR CLOG. 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 /> am a registered bull0er OR ( )the ,u hor zea epresen a ye SIGNATURE OF APPCICANT: <br /> <br /> AUHoVD,J,,.L OR 97,~25 i~ARION COUNTY ~ ,OCCUPANT LOAD: <br /> ' Nd <br />~0~E' ~ '~iESi~i ........................................................................................ <br />MAILING AOS~ .................................................. ~ S 'UBDIVI~IONI <br /> <br /> SAH~ ~ ........................... <br /> PHONE: 7~9-'~'~ SITE HUmBeR: <br /> ~ ~.~ VALUATION: <br /> <br /> NO <br /> <br />TYPE: ELECTRICAL <br /> <br />L ICF'I4SE I,t0.~ <br />SfURD.f. VAHT, s'rEVE & CAROL <br />,o;. A MI.-". <br /> <br />PERMIT OR APPLICATION HO: 54987 <br /> <br /> SUPERVISING ELECTRICIAN/MUHBER <br /> <br /> :I:'rEM <br />REC, ONNEST ON/.Y <br />ELECTRICAl.. STATE S JRC:ARGE <br /> <br />QUANTITY AHOtJNT <br /> 1 $40.00 <br /> $2,00 <br /> <br /> TOTAL ASSESSED FEES $4~,,.,,00 <br /> PREVIOUS RECEIP'f'S $0.90 <br /> THZS RECEZP'r <br /> !: <br /> :'BALANCE DUE <br /> <br /> ~g~,...~IUR~IVAFIT~ STEVE& CAROL RECEIPT h!O: ~'7458 <br /> ~nu~lVk,~ BY: PB , TYF'[;= OK CHECK ~: 4882 <br />* THI~ IS A VALID PERHIT EXPIRES 188 BAYS FEOH ITS ISSUE DATE. <br />COflSTRUCT~ON CEASES FOR A :OR IF CONSTRUCTION FAZLS TO ~EET ALL <br />SH~LL RECOHE NULL AN~ VOID, <br /> <br />REHAFd(S: RECONMECT <br /> <br />O}I~AI9 E,, WOODI_EY~ MARION COUNTY BUILQIMG O, FICIAL / BY <br /> <br />FORM # MC 1 $,$6 REV, 4i90 OFFICE COPY <br /> <br /> <br />