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05/~3/~ ~0~ 07'.41 FAX $05 304 <br /> <br /> ~in~ ~y: Ci~:.,, <br /> R~tpt ~ = ~n~ $ <br /> <br /> ELEC~CAL ~ APP~ON <br /> P~e eo~ a~ ~c~, I th~ug~ 5 <br /> <br /> ~ON 0~,~0~ <br /> Own= <br /> <br />NORTHSIDE ELEC, <br /> <br />[~002 ~ <br /> <br /> MARION COUNTY BUll, DING INSPECTION <br /> 3150 Lancaster Dr. ~ - Suite C <br /> Salem, O ~g,z~. 97305 <br />4:~0pm 24 HR Inspection Linc 373~4,427 FAX 588-7948 <br /> <br />4. FEE SCHEDULE (~ompl~u end enter total in A~.) <br /> <br />A2, Add Sta~ <br /> . ~ ~*qo SUBTOTAL $.~ <br /> <br />D, Re~on Fcc ($~0.~) $ <br />F. lm~flon ~ w~ch no fee is s~ifi~lly in~c~ <br />(~, ~m two h~) $ <br /> <br />MC 15.34 R~v 9/98 <br /> <br /> <br />