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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO. 225 <br />220 H~GH STR._~ET NE, <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 ~ 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />The work will be performed by a registered builder. <br /> <br />I have read and agree to the terms stated on the reverse side <br />this document, <br /> <br />, AUMSV L OR 97~5 Au~v~,LE NO <br /> <br /> 5~TE NU~ER: <br /> PHONE: ~63-6~4 ~ VALUATION: <br /> <br />i , ; ~ , <br /> <br /> L ' <br />' 8~ 82 &97-~ SF L.N8 ~ ..-NC <br /> <br />TYPE: ELECTRICAL <br /> <br />CONTRACTOR~ NO. <br />LICENSE NO: <br /> Quantum Electrical Constructio <br />1474. ~Sth Ave NW <br />$aleM~ 77~4-0808 <br />PHONE: ~62-4191 <br /> <br /> ITEM <br />BRA~CH CIRCUIT~.WITNOUT SERVICE,OR FEEDER - 1ST CIRCUIT <br />ELECTRICAL STATE SURCHARGE: <br /> <br /> TOTAL ASSESSED FEES <br /> PREVIOUS RECEIPTS <br /> THIS RECEIPT <br /> ,:BALANCE hOE <br /> <br /> PERHIT OR ~PPLICAT~OH MO: 5&~4~ <br /> <br />79524 SUPEBVISIN~ ELECTRICIAN/NUMBER <br /> <br />QUANTITY AMOUNT <br /> 1 $35.00 <br /> $1.75 <br /> <br />$36..75 <br /> $0.00 <br />$56.75 <br /> <br /> PAYEE: Quantum Electrical Om~s~ru~t~6m :inc: :: RECEIPT NO: 5884; <br /> RECEIVED BY: DM ................. ~.~. .... ~ ......... TYPE: ~K CME~K ~: 1S54 <br /> <br /> ; TWZ~ I~ A VALID 188 ~AYS FROM ITS ISSUE DATE. IF <br />COHSTRUCTIOH CEASES FOR A PERIOBOF, 188~DAYS, ORIF COHSTRUCTIOH FAILS TO HEET ALL <br />REQUIREMEHTS OF STATE LA~S; AN~: HARIOM COUtJTY BU~LDZHG AND ZDH[NG ORDIHAHCES~ THIS PERMIT <br />5~ALL BECOHE HULL AH~ VOID: <br /> <br />REMARKS: 1 gIB FOR FURNACE <br /> <br />DONALD E. WOO~LEY~ MARION 6OUN~Y: BUILDING OFFICIAL / BY <br /> <br />OFFICE COPY <br /> <br /> <br />