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MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> <br /> 285 Church Street NE · Room 132 · Salem, Oregon 97301-3670 <br />Office Hours: 8:00-4:30 · Phone: (503) 588-5147 · 24-HR Inspection Line: (503) 373-4427 <br /> <br />WORK DESC : HFG SVC <br /> <br />SITE ADDRESS : CITY: AURORA <br /> <br />29808 HIGHWAY 99E NE AR <br /> <br />CROSS STREET I OTTAWAY <br /> <br />PARCEL NUMBER : 90199-080 <br /> <br />OWNER NAME = POOL,JERRY E & RACHEL <br /> <br />APPLICANT <br />HAME : POOL, JERRY <br />ADDRESS I 20808 HIGHWAY ??E NE <br /> AURORA OR <br /> 97962 <br />PHONE : 678-5407 <br /> <br />COHTRACTSR : POOL. ,JERRY OCCB= <br /> PHONE t 678-5407 <br /> <br />ELECTRICIAN = CONTRACTOR LICENSE: <br /> PHONE <br /> <br />SUPV ELEC : SUPERVISOR LICENSE: <br />PHONE : <br /> <br />Units Description Fee <br />] Manf dwelling service/Teed 40.0~ <br />1 State surcharge 2.00 <br />! Refund <br /> <br /> Assessed fees : 42.00 <br /> Adjustments : .00 <br /> Total fees : 42.00 <br />PAYEE: POOL~ JERRY Total payments= 42.00 <br /> Balance due : ,00 <br /> <br />THIS PERfllT IS NON-TRANSFERRBLE AND EXPIRES 18g DAYS F~ I~ ~TE IF ~RK HAS <br />~ ~D, ~ IF ~T~I~ ~S F~ ~ ~IOO ~ 1~ ~YS, ~ IF ~K <br />F~ILG TO ~ET RLL~XRE~g ~ STRTEL~ ~ ~I~ GOUTY ~IN~5. UPON <br />~I~ ~gT, ~IX N~ E~I~ ~Y ~N~, <br /> <br />SIGNATURE OF APPLICANT: <br /> <br />DOflDALD E ~O00LEY, HARION COUNTY BIJILDINBO OFFICIAL / BY CLYHCH <br /> <br /> <br />