Laserfiche WebLink
MARION COUNTY BUILDING INSPECTION <br />SENATOR SLDG,, 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 /> ~ 8m performing work on 8 property I own Or Oocupy. <br /> I am ~.registered builder OR the authorized representative <br /> o¢ a rugistered builder, <br /> I The work will be performed by 8 registered builder. <br /> Other__ <br /> I have read and agree to the terms sfsted on the reverse side of <br /> this document. <br /> [;)ATE: 06/09/8? TIME'- 2;29:48p <br />OWNER; E~LAYLOCK, VERNON <br /> <br />SIGNATtJR~ OF APPLICANT: <br /> DATE: <br /> <br />TAX LOT: <br /> <br />CATEGORY: R <br /> <br />SITUS ADDRESS: <br /> <br /> 94-6? STAYTON RB <br /> AUMSVILLE OR 9?325 <br /> <br />USE OF BUILDING: <br /> <br />SE <br /> <br />CONSTRUCTION TYPE; <br /> <br />OCCUPANCY'. <br /> <br />OCCUPANT LOAD: <br /> <br />MAILING ADDRESS: <br /> <br /> SAME <br /> <br /> PHONE: 769-6187 <br /> <br />SUBDIVISION; <br /> <br /> SITE NUI~ER: <br /> VALUAT I ON t <br /> <br />1194 <br /> <br /> TOWNSHIP: RANGE: <br />24 9S <br /> <br />ZONE; <br /> <br /> MAP: <br />EFU 64 <br /> <br />1~, +0000UNITS; A~ IRIWE6 LOT; N CORNERI N <br /> <br />'TYPE; ELECTR~ <br /> <br />CONTRACTOR, NO. <br />LICENSE NO: <br />BLAYLOCK,VERNON <br />SANE <br /> <br />PER~ZT OR APPLICATION NO; <br /> <br />2609 <br /> <br />SUPERVISING ELECTRICIAN/NUMBER <br /> <br />PHONE; 769-6187 <br /> <br />SERV CHANGE ONLY-IEKISTING RESIDENCE <br />ONE NE~ BRANCH CIRCUIT;ALTER OR EXTEND <br />FLEET SURCHARGE -ZONE 3 <br />ELECTRICAL STATE SURCHARGE <br /> <br />TOTAL ASS~ED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />8AI_C~CE ODE <br /> <br />QUANTITY <br /> 1 <br /> 1 <br /> <br />fM4OUNT <br /> ~2O.OO <br /> 15_B9 <br /> ~3.84 <br /> 1.40 <br /> <br /> $40_24 <br /> $40.24 <br /> $0.00 <br /> <br />PAYEE: BLAYLOCK,VERNON RECEIPT NO: 3114 <br />RECEIVED BY: c] TYPE: OK CHECK ~: 6459 <br /> <br />~ THIS I8 A VALID PFJ~4IT TM THIS, P£RNIT EYJ~IRES 180,DAYS FROM ITS ISSUE BATE. IF <br />CONSTRUCTION CEASES FOR A PERIODOF 180 BAY$¢::ORIF C~NSTRLICTION FAILS TO MEET ALL <br />REQUIREMENTS OF STATE LANS AND t~J~ION'COUNTY BUILDING AND ZONING ORDINANCES, THIS PERMIT <br />SHALL BECOME NULL ANDVOID. <br /> <br /> ¢-.'~¥ ,..~ <br /> <br />DONALD E. NOODLE'Y, NARION COUNTY BUILDING OFFICIAL / BY <br /> <br />OFFICE COPY <br /> <br /> <br />