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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 /> ELECTRTCAL APPLICATION <br /> T~'T[/TTHE ~ ~7/~2/96 1&)5~ ACTIVITY HO : 96-~S473 <br /> ' C~rcta] addittan/e)teration STATUS : <br /> <br />OCCUPANCY : E-t APPLIED <br /> TO EXPIRE <br /> <br />WORK PFSC : ~,-~ AMP .VC, 3 2~ AMP F~RS~2~ CIR FOOTBALL <br /> <br />SITE AOQR.SS :: ~81~7 GRIM RQ NE AR CITY: NARION COUNTY <br /> <br />.Rfl, S STRF'FT : BflONFS FFRRY RD <br /> <br />~ARCEI. NIJMI~ER : <br />OWNER NAMF : <br /> <br />APPI.. ICANT <br /> NAMF <br /> AI)I)RES~ <br /> <br />4~712-00~ <br />NilRTH MAR]TiN S[.HEOI. DIST NO 15 <br /> <br />970~? <br /> <br /> : DRYI)FN FL FCIR]'C <br /> : PO BOX 244 <br /> <br /> HklBBAR~), OR <br /> PHONE : 981-:~91:~ <br /> <br />CONTRACTOR : ~)RYT)FN /IFCI'R]C INC OCCB: <br /> PHONF : <br /> <br />FL FC1R~CTAN : CONI RACTOR LICENSE: <br /> PHONF : <br /> <br />SIIPV ~I,FC : S[IPERV3SOR LICENSE: <br />PHONF <br /> <br /> Servi~e/feed~rs u9 to 2~ amps <br /> S~rv~rP f~erler's, ~0:!-18~0 amps <br /> ~ Br~nch c'kr cui'l:~ <br /> ~ State surcharge 16.~0 <br /> 1 R~fund . <br /> <br /> Assessed 'fees : 336.00 <br /> ~d.iustMents : .08 <br />PAYFF: ORYOEN FI F II'RTC ~NC Total paxMents~ 288.75 <br /> <br />~TB T~ ~T A P~RH]T. TT ~ ~ RESPONBTBILITY ~ T~ ~PLlCANT TO ASSURE THAT <br />AI.I. NECE~Y T~OR~T~ ~ ~OVIOEO AND F~B PAID ~F~E A PERHIT HAY ~ ISSUED. <br />SIr;NATURE 0F APPI ~CAN¢: ............................................................ <br /> <br />~ONA1 )~ F. WO0~I FY~ MAR~HIN COUNTY BU~I D~N~ OFFICIAL BY CLYNCH <br />............................................................ FOR i)FFI:CE ISE ONLY ............................... <br /> <br /> MAFh~ 70NF: PROPER'fY I OCATOR~ <br /> <br />F' AN RF:V' -:'W~ I)ATE: ZONING REVIEW: DALE: <br /> <br /> <br />