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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-PHONE; 588-7904 <br /> <br />¢ a regigtered <br /> <br />CONSTRUCTION TYPE; 'J OCOUPANCY; <br /> <br />TYPE: ELECTRICAL <br /> <br />PERNiT OR APPLICATION NO= 9854628 <br /> <br /> SUF'ERV:I:S ING Ei._F C TR I (::]: AN/NUHI~ER <br /> <br />TOTAL ASSESSE~ FEES <br />PREVIOUS RECEIPTS <br />THIS. RECE;~PT <br /> <br />QUANT:CTY <br /> <br /> $2 ,, ('~g~ <br /> <br />~ ,L ,,~] <br /> $~,, gib <br />$4 2. ~a~/b <br /> <br /> PAYEe.',,; FOM.r. NAq,, ';: .,: . REC~.IPT NO-" 57fa92 <br /> <br />~ ~ THI I~ NOT A P/RM~ fRI~ ~PP~IC~TI:~H MUST GQ THROUGH A REVIEW PROCESS WHERE THE <br />,-OLLOWIH6 MUST BE COMPLETED.:,:':%T :~S THE RESPONSIBILITY OF THE APPLICANT TO ASBURE THAT <br />ALL NECESSARY INFQE~ATIOE <br /> <br /> RE~ARKS;¢ MS f~::RV]CE ,' <br /> <br />FORM # MC 1 ~_~6 RE~¢. 4/90 OFFICE COPY <br /> <br /> <br />