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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLJ~G. NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 588-5147 <br /> COOE-A-PHONE 4:30 P,M, - 6:00 A,M. <br /> <br />I am performing work o~ A Otopef[y I Own or occupy. <br />t am a registe?ed bdl~te? OR he au hor zed rep?esen a ye <br /> <br />· IGNATUR~ O,~ AP~'UCANT: ........................ <br /> DATE', ......... <br /> <br />[)ATE: 11/18/87 <br /> <br /> ~L~ OR 97002 ~ ~ . <br /> ...................................... ~ ....................... L......NO ................ <br /> <br /> 21294 LI~ER~ ST. NE ~ 97002 <br /> ~E~ 67~-54~? ~ SITE NU~ER= 2!66 <br /> , ~ VA~ATI~,: <br /> <br /> TYPE( ~-S:ITE S~E <br /> <br /> m EXISTING T~K ~IZE: <br /> <br />~H~E: 678-5497 A <br /> <br /> · . ":'":' .~[~S eeCE~P~..- <br /> · ' '::'~6E,",~,. · : ,,:" · $0 0C <br /> <br />R~CEIV~D BY ~ ,, · ...... .,, <br /> ..... ',; ~ ,,," ...... ~L2"' <br /> <br /> <br />