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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO 225 <br />220 HIGH STREET NE <br /> SALEM OREGON 97301 <br /> <br /> PHONE 588-5147 <br /> CODE-A-PHONE 4::30 P.M.. - 8.00 A.M. <br /> <br /> I am perforrning work On a property I owr~ or occupy' <br /> I am a reg~sfered budder OR ( ) the authorized representative SIGNATURE OF APPLICA <br /> of a registered budder <br /> The ~ork wdl be performed by a registered builder <br /> Other <br /> I have read and agree to the terms stated on the reverse side of CATE <br /> this document <br /> <br /> DATE: 06/01/87 TINE: 2.* 39.' 26p <br />OWNER TAX LOT <br /> CHARTERS, CLAUDE <br /> <br /> 7276 SHERMAN RD SE <br />AU~;SVILLE OR 97325 CONTRACT CITY UGB <br />NC N <br /> <br />gSF OF BUILDING <br /> <br /> PHONE: 749-1772 <br /> <br />LOT gt. OCK SECTION TOWNSHIP <br /> 28 SS <br /> <br />WIDTll DEPTH AREA 8. 50000U N IT'~ AC <br /> <br />SITE NUN~9 ER.* <br /> VALUATION <br /> <br /> 1W <br /> <br />CATEGORY <br /> R <br /> <br />OCCUPANCY <br /> <br />OCCUPANT [OAC <br /> <br />1528 <br /> <br /> MAP <br /> RA 48 <br /> <br /> N <br /> <br />TYPE= ELECTRICAL PERMIT OR APPLICATION NO: <br /> <br />2443 <br /> <br />CONTRACTOR, NO. 34211 <br />LICENSE NO: <br />O D ELECTRIC IvOTOR SERVICE <br />519 CENTER ST S <br />SUBLIMITY, ORE 9?285 <br />PHONE: 769-2042 <br /> <br />,SUPERVISING ELECTRiCIAN/NUNBER <br />159CPI <br /> <br /> ITEM <br />ONE NE~ BRANCH CIRCUIT;ALTER OR E~KTEND <br />FLEET SURCHARGE -ZONE 2 <br />ELECTRICAL STATE SURCHARGE <br /> <br />QUANTITY <br /> 1 <br /> <br />TOTAL ASSESSED FEES <br />PRB~CIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />SAL,~C, ICE DUE <br /> <br />PAYEE: D D ELECTRIC MOTOR SERVICE <br />RECEIVED BY: dm <br /> <br /> RECEIPT NO: <br />TYPE: CA CHECK <br /> <br />AP'K)UNT <br /> $15.00 <br /> $2.56 <br /> $o.6o <br /> <br /> $18.16 <br /> $o.oo <br /> $18.16 <br /> <br /> $o,oo <br />2939%'%1 <br /> <br />* 'BIS IS A VALID PFJ~IT * THIS PERHIT EXPIRES 180 DAY~ FROM ITS ISSUE DATE. IF <br />CONS'FRUCTION CEASES FOR A PERIOD OF 180 DAYS. OR,IF,::C~NSTEUCTION FAILS TO t~ET ALL <br />REOUIREHE~r'r~ OF STATE LAH8 AND NARION COJNTY BUILDING AND ZONING ORDINANCES, 'THIS PEF~IT <br />SHALL BECOHE NULL AND VOID. <br /> <br />REMARKS: WELL ~ <br /> <br />DONALD E. ~OODLEY, HARION COUNTY BUILDING OFFICIAL/ BY <br /> <br />OFFICE COPY <br /> <br /> <br />