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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO, 2;25 <br />220 HIGH STREET NE <br /> BALEM, OREGON 97301 <br /> <br /> PHONE: B88-5147 8:00 - 4:30 <br /> 24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />famperforrilirlgwo¢konapropertylownoro¢Oupy. ~~ /~ ~ <br />I am a registered builder OR the authorized representative SIGNATURE OF APPLICANT~ ' <br />Of a registered builder, <br />The work will be pedormed by ~ registered builder. <br />Other <br />I have read and agree to the terms stated on the reverse side of DeTE; <br />this document. <br /> <br />i 6WI~? ..................................................... 0 A Fl... ,,:'~ ~8/.[ ,.J/f~4' · vl .... f~12'" .... 8..z_, ~ 43" ~--73~. ................ ~'A-X- Ebb-7 ................................. C~T~GQRY: ' <br /> <br /> L ..................... r-o'- ~ ............. <br /> <br /> ~'~,~ ~TH CONTRACT CITY. J G : !OCCUPANT LOAD; <br />O'~ 'dK euii6'~SV.l:DE~ .................... 0'~ ~-'rP~ .............. ~IT~$VI'EE'E ........... N[J' ........ !NO. OF BEORCJCJM$ <br /> <br />MAILING .......................................................... ADOI~ES~ ~-~0 ~6~l~l~-N~' ........................... <br /> <br />PO ,SOX 584 <br />AUilSV!:LLE (:lR [27~25 / SITE NUMBER: 74-~2252 <br /> <br />TYPE~ ELECTRZCAL <br /> <br />C0~TR~CTOR~ NO. <br />LICENSE NO: <br />RAGSDALE,, MICHAEL <br />PO BOX 584 <br />AUHSVILLE OR ~7~25 <br /> <br /> ITEH <br />~R~N~H C~RCUIT WITHOI <br />BRANCH CIRCUIT <br /> <br /> PAYEE: RAGSDA~E, MICHA <br /> RECEIVE~ BY: ~s <br /> * THIS IS A VALID PERH~l <br />CONSTRUCTION CEASES FOR~A <br />~EDU;RE~EHTS OF STATE <br />SHALL BECOHE HULL AND <br /> <br />PERMIT OR APPLICATION ND: 57362 <br /> <br /> SUPERVISING ELECTRIC]:AN/NUMI~ER <br /> <br />: OR <br /> <br />Q U AIq T I T Y A M £$tJ N T <br /> 1 $$5 ,, ~.' <br /> <br /> $2.55 <br /> <br /> RECEIPT NO." 59872 <br /> CHECK ~,: 23:~5 <br /> <br /> FAILS TO MEET ALL <br /> <br />:: <br /> <br />RIENAIRK$." ADDITION <br /> <br />DONALD ER. WOO~L_EY~ MARl, ON :::COUI,I: ~ B :~IIqG?" <br /> <br />OFF[CE COPY <br /> <br /> <br />