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MARION COUNTY BUILDING INSPECTION <br />SENATOR OLDG, NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:$0 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> performing work on a property I own or occupy, <br /> <br />DATE~ 121011?4 T~rME= 9:~B~6 <br /> <br /> ....... ~ N~'C~UCTIO N T~PE'. ; OCCUPANCY: <br /> <br /> 13036 HAPLE LEAF CT NE <br /> <br /> SiTE NUMBEE= ~4-84~12 <br /> PHONE:~ 678-25~I j VALUATIQN= <br /> <br /> T~'~E: ELECTRICAL PERHIT OR APPLICATION NO: <br /> CONTRACTOR~ NO, 25644 SUPerVISING ELeCTrICIAN/NUMBER <br /> Hoga~'~ ~:).ec~ric Co <br /> <br /> Pot tla~d~ 97~66-~00 <br /> FHQNE: 774-8824 <br /> <br /> ITEM QUANTITY AMOUNT <br /> BRANCH CIRCUIT~ WITHOUT SERVI~ OR FEEDER ~ 1SI' CIRCUIT 1 <br /> ~RANCH CIRCUIT. WITHOUT S~RVII.E OR FEEDER EACH A~DITIONAL 1 <br /> ELEOTR~CAL ~TATE SURCHARGE $1.85 <br /> <br /> . TOTAl.. ABSESSE~ FEE9 $J8,,85 <br /> :~ PREVIOUS ~ECEIPTS <br /> <br /> PAYEE: HO(laDS ,Electric CO:::~H8 ::: : . RECEIPT HO: <br /> RECEIVE~ BY: ~s TYPE: CK CHECK ~: 2e~4 <br /> <br /> ~ THI~ IS A VALID PERNIT 18~: D~YS FROH IT~ ISSUE DATE. <br />CONSTRUCTION CEASES FOR R PERIOD OF~'lOe CONSTRUCTION F~ILS TO flEET all <br /> <br />SHALL ~EBONE NULL ¢N9 <br /> <br /> REMARKS: 2 CIR NO SERVe;CE <br /> <br />DONALD E. b)OODLEY~ <br /> <br />MARION COUNTY BUILDI:N[; OFFICIAL :/ BY <br /> <br /> <br />