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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 - 4:3o <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am 8 registered builder OR ( ) the authorized representative <br />The work will be pedormed by a registered builder, <br /> <br />.... I)A I ;.., ,~ ,. 7~.~,/~8/)4 ..... ~ IN ..... :J. ~,,,,,4 ~. ~]7 ' ~Ax LO~' ~ CXfECdkv; <br />OWNER: ~ -, , <br /> BOCHSL. ER,~ RALPH , 6'20~4-,~ ~RES:~tDEN')"IAL <br /> <br /> ',~:~ H SAH~'.[~H HWY , ---- ~'~6~fRACTCITY'. ~U~B: ~OCCUPANTLOAD; <br /> l);"fR[ )'T OR 97 ~42 ~ETROIT <br /> <br /> ,:~TAY,~J~I~ OR ~7~8~ ] SITE ~UNBER: <br /> F'HONE'.: 769'-'648D ~ VALUAT~ON~ <br /> <br />TYPE: ELECTRICAL <br /> <br />PERHIT OR APPLICATION NO: 57163 <br /> SUPERVISIN(; ELECTIr(t C:[ AN/NUHBER <br /> <br /> ]: T E M <br />SERV.[CIz/I-EF.D,~R LESS ~HAN ,~,0~ <br />BRANCH CtRCUIT~ WITH SERVICE OR FEEDER <br />ELECTRICAL oThl'~ ~J'~CHARGE <br /> <br />TOTAL ASSESSE9 FEES <br />PREVIOL8 RECEIFTS <br />:~HIS'RECEIPT <br />~AL~C~ 'gUE <br /> <br />$0,00 <br /> <br /> ~ tlYLI.,,. I aczfzc C~,~As~. ,]Ll.~'t~ zc :i:.~c RECEIPT NO. <br /> I~t~:CE:[VE1) BY: MB ~¥~A ~N.,...~_L,4__ ......................... TYPE: CK CHECK ~: 728~ <br /> <br />SHALL BECOHE N~LL AN~ VOI].. ' , ,, ', ,' <br /> <br /> I)ONALD [. WOODLFY, NAEION COUntY ~[JIL~IN~, OFF],CIAL / BY ................................................................................ <br /> <br />OFFICE COPY <br /> <br /> <br />