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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 /> ELECTRICAL PEA'HIT <br />DATE/TZHE '- ~6/27/96 '14,:L7 PERflIT NO ~ 96-g,4778 <br />TYPE : Resident. addition/alteration STATUS : ISSUED <br />OCCUPANCY c R-3 ISSUED : S6/27/1996 <br /> TO EXPIRE z 12/24/1996 <br /> <br />WORK BESC : 1 MH FEEl)ER, 2 SEE AND 2 CIE <br />SITE ABBRFSS : CITY: MARION COUNI'Y <br /> 8973 SHAW SQUARE SE AM <br /> <br />CROSS STRFET <br /> <br />PARCEL NUMBER : 75388-361 <br /> <br />OWNER NAME : AMSBERRY,VELONI B <br /> <br />APPLICANT <br />NAME : PACIFIC COAST ELECTRIC INC <br />AI)I)RESS : PO BOX 651 <br /> <br /> STAYTOH, OR 97383 <br />PHONE : 769-7671 <br /> <br />CONTRACTOR : PACIFIC COAST ELECTRIC INC' OCCB: 8045?33 <br /> PHONE : 769-7671 <br /> <br />FtFCTR~CIAN : PACIFIC COAST ELECTRIC INC CONTRACTOR LICENSE: 24-192C <br /> PHONE : 769-7671 <br /> <br />SUPV ELEC : GILLETTE ROBIN ALLEN SUPERVISOR LICENSE: 3653S <br />PHONE : GILLETTE ROBIN ALLEN <br /> <br />Un~ts Description Fee <br />1 ~anf dwelling servi~e/~d 40.00 <br />2 ~erv~ce/T~eoers up ~o z~ amps 188.88 <br />2 Branch circuits 4.88 <br />1 State surcharge 7.28 <br />1 Refund .88 <br /> <br /> Assessed fees : 151.20 <br /> Adjustments : <br /> Total fees : 151.28 <br />PAYEE: PACIFIC COAST ELECTRIC INC ~o~al paxMents: 151.28 <br /> ~aiance due : <br /> <br />TH~ PERHIT IS NON-TRAHSFERABLE ~ND EXPIRES 18~ D~YS FROfl ISSUE 9~TE IF WORK HAg <br />NOT COi~ENCEDs OR IF CONSTRUCTION CEASES FOR A PERIOD OF 18B 9~YS. OR IF gORK <br />FAILS TO flEET N.L REQUZREHENTS OF ST&TE Ll~S &ND fl~RION COUNTY ORDIN&HCES. UPON <br />gRZTTE# REGUEST~ OflE SZX HONTH EXTENSION HAY ~E r. RN~TED. <br /> <br />SIGNATURE OF APPLICANT: <br /> <br />******************************************************************************~ ~.'t--'- <br />PONPALI) E WOOBLEY, MARION COIlNTY BtlILBINBG OFFICIAL / BY LIDAVIS <br /> <br /> <br />