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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 />work will be perCormed by a registered builder. <br /> <br /> i CAT,GORY; <br />~(L~AF(I,[.Iq ~ E~ T 1 ZB~ B E S I ~E N T Z ~ L <br /> <br /> 575~ F'IL. BE~T CREEK LANE SE ~-~6h'~XSf'Sif~ '~' O~& <br /> ~UHSVILLE OR 97~25 ~RION COUNTY ~0. <br /> <br /> 2;54 HO. CEN'FE~ <br /> SUBLIHITY 97385 SITE NUMBER: <br /> PHONE: 769-7596 VALUATION: <br /> <br />TYPE: ELECTRICAL <br /> <br />CONTRACTOR, <br />LICEN,~E NIl,. <br />~][LPiARTII,I, PAT <br />2;54 NO. CENTER <br />SUBLIMITY <br />F'NONE: <br /> <br />PERMIT OR APPLICATION NO: ?B6~12~,7 <br /> <br /> SUPERVISING ELECTRICIAN/NUHBER <br /> <br /> ITEM <br />SER¥]:CE/FEEDER LESS THAN 288 AMPS <br />PUHP OR IRRIGATION CIRCL~ <br />ELECTRICAL Sl'AlE SLIRCHARGE <br /> <br />F'AYEE: KILMARTII,I~ PAT <br /> <br />OTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS.RECEIPT <br /> <br />BA.ANCE DUE <br /> <br />OUANTI')'Y AMOUNT <br />I $50.00 <br />t $42.00 <br /> $4.52 <br /> <br />$94.52 <br /> <br />$~74,,52 <br /> <br />$0.22 <br /> <br />RECEIPT 140: 62900 <br /> <br /> R~;'CEIVED BY: js TYPE,, CK CHECK ~: 1422 <br /> <br />FOLLOWING HUBT BE COMPLETE~. IT IS' THE RESPONSI~[L~f~-'~-T~"~¢¢r~n~"6~ ~ <br />ALL HECESSARY INFORMATION HAS BEEN PROVIDE~. _ ............................... <br /> <br />PI_AH REVIEkI: BY .......... DA~I'E__.L, ......... <br />RI!2HARKS: 1 FEEDER. TO POLE BLDG, I PUMP <br /> <br />CITY JURISDIC'r~ON: <br /> <br />BY ............... DATE <br /> <br />OFFICECOPY <br /> <br /> <br />