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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 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />OWN(~,~ FB: 02/11/91 <br /> <br /> COUNTRY CA~LB <br />SlfUS ADDRESS: <br /> <br /> 9143 N S'fAY'f'ON R0 <br /> <br />USE OF SUIL01NG: <br /> <br /> OR , <br />......... iI'4AR 1 ON 'O~Ul',l"f Y~ ...... NO <br /> <br />t2;t8':49 I ~Ax LOT: CATEGORY: <br />RES1 DEN l' ~AL <br /> <br /> PHONE <br /> <br />LOT: <br /> <br />SiTE NUMBER: <br />, VALUAZiOB; <br /> <br /> NO i NO <br /> <br />TYPE: ELECTRICAL <br /> <br />CONTRACTOR, NO- COUNTRY <br />LICENSE NO: <br />COUNFRY CABLEVJSION LTD <br />7522 JORDAN S'I' SE <br />~ALEM, OR 97301 <br />PHONE: 588-8247 <br /> <br />PER~I'F' OR APPLICATION NO: 30315 <br /> <br /> SUPERVISING ELEC'T'RiCiAN/NU~ER <br /> <br /> ii'EM <br />SERVICE/F'EEDER 100 AMPS OR LESS <br />~LEC'I'RiCAL STATE SURCHARGE <br /> <br />PAYEE: COUN[RY CABLE¥1SION L'FO <br /> <br /> :FOTAL~ED~EE~ <br />PREVZOU~RECEiPTS <br /> THiS RE~EiP'F <br /> <br /> BALANCE FAJE <br /> <br />QUAN 11 'T'Y AMOUN'I' <br /> $35_ 00 <br /> <br />RECBiP'I NO: <br /> <br /> $o_oo <br />$3B,'Z5 <br /> <br />$0.00 <br /> <br /> 32039 <br /> RECgiVED BY: o"l TYPE: CK CHECK ~: 0 <br /> * TH~S ~S A VALID PER~IT ~: THIS: P~I:~tI~.:EXPZ.RE~ 180 DAY~ FRO¢,I iTS I~E DATE. ZF <br />CONSTRUCTION CEA~EE~ FOR A PERiOD:OF: ~. OR iF ~8T~CTi~ FAI~ TO ~EET ALL <br />RE~IR~TS OF STATE ~D~RI~ ~NTY BUiLBING:~D Z~iNG ORBIN~C~, THiS PE~IT <br />~ALL B~E NULL ~D ~ID. <br /> <br />REMARKS: 100 AMP CABLE PP~L 015800 <br />DONALD E. WOQOL~Y, MARION COUNTY BUILDING O~P'ICIAL / BY ........................................... ~ ..................................... <br /> <br />FO"M ~ MC is-se n~. 4,~o OF FICE COPY <br /> <br /> <br />