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MARION COUNTY BUILDING INSPECTION <br />SENATOB BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> 588-5147 <br /> CODE-A-PHONE 4:30 P.M. - 8:00 A.M, <br /> <br />, .m performing work on a property , own or oc rugy. <br />I am a registered builder OR the au hori;~ed rep esen a ye SIGNATURE OF APPLICANTr. <br />of a registered builder, <br />The work will be Performed by a registered builder. <br />Other, agree on reverse side of OATEZ <br />I have read and ,o the ter,,, stated the <br />this docvment, <br /> <br /> TIME: 11:42:17m <br />PETER & KAREN <br /> <br />OR 97325 <br /> <br /> 0ATE: 04/12/88 <br /> GAUTH I ER, <br /> <br />SITUS ADDRESS: <br /> <br /> 810 ?TH ST. <br /> At,JNSV I LLE <br /> <br /> TAX LOT. CATE3ORY <br /> RESiDENT~A;._ <br /> <br /> CONSTRUCTfON TYPE OCCUPANCY <br /> <br /> CONTRACT CIT~ UGB OCCUPANT LOAC; <br />ALMSVILLE NO <br /> <br />MAILING ADCFIESS SUBDIVISION <br /> =AIR OAKS ESTATES <br />SANE <br /> <br /> PHONE= 74-9-2932 SiTE NUMBER= ~._ '3787"~ <br /> VAL.UAT I QN '- '"-"- --' <br /> <br /> 18 3 25 8S 2W RS .n- <br />WIOTH: S 1 DEPTH: 95 AREA' ?~95 . 00 UNITS: SE RREG. ;-07 NO COR~ <br /> <br />TYPE; ELECTRICAL PERMIT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. <br />LICENSE NO: <br />GAUTHIER, PETER & KAREN <br />SAME <br /> <br />PHONE; 749-2932 <br /> <br /> ITE~ <br />TWO OR MORE NEW CIRCUITS;ALT OR EXT <br />FLEET SURCHARGE -ZONE 3 <br />ELECTRICAL STATE SURCHARGE <br /> <br />SUPERVISING ELECTRICIAN/NUNBER <br /> <br />QUANTITY AMOUNT <br /> q $20.00 <br /> $3.84 <br /> <br /> TOTAL A,SSESSED FEES :~24.84 <br /> PREV~OU,S RECEIPTS $0.00 <br /> THIS RECEIPT $24,84 <br /> BALANCE DUE $0. O0 <br />PAYEE: GAUTHIER, PETER & KAREN :,,RECEIPT NO; 8424. <br /> ~_3 <br />RECEIVED BY: J8 .............. ... ............ ~_._~__ , TYPE: CK CP ECK <br />~ THIS IS A VALID PERNZT ~< PERNIT EXPTRES 180 DAYS FRON TTS ISSUE BATE. IF <br />CONSTRUCTION CEASES FOR A.PERIOD ,OF FAILS TO REET ALL <br />REQUIRE>lENTS OF STATE LAJA~ AND MARION COUNTY ~UILDING.:AND ZONING ORDINANCES, THIS PERh3ZT <br />.SHALL BECONE NULL AND VOID. <br /> <br />REMARKS: CIRS. R:~9657 SELF <br /> <br />DONALD E- WOODLEY, HARION COUNTY 8UILD~rNG OEFTCZAL: /BY <br /> <br />FORM ¢ MC 15-!,6 REV 6/87 OFFICE COPY <br /> <br /> <br />