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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH $'TREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE $88-5147 <br />CODE-A-PHONE 4:30 P.M. - 8:00 A.M. <br /> <br />ol a registered builder, <br /> <br />Other <br /> <br /> DATE: 12/11/87 TIME,~. 9:0"/.'48a <br />OWNER; ; TAX LOT'. <br /> <br /> LUTZ, TROY & STARR E. I <br /> <br /> I CA'rEOORY: <br />56124-000 I <br /> <br />R <br /> <br /> 6898 SHEI~AN RD SE i CONTRACT CITY; i UGB; <br />' AUMSVILLE OR 97325 ~ i ~ <br /> ............................... ~ P-,.T~N .~COON~ ........ ~... -.NO ~ <br /> <br />SANE <br /> <br />PHONE~ 749-2169 <br /> <br />LOT BLOCK: <br /> <br />WIDTHZ iDEPTH; <br /> <br /> ~ SITE NUMBER:: 3023 <br /> [ VALUAT~ ** <br /> < RANGE'. i ZONE: ; M~P: <br /> <br /> 20 i 8S ~ 1~ ~ EFU 48 <br />~ 10 ~ 0000 ~ ~ NO ~ NO <br /> <br />TYPE;' ELECTRICAL PEI:~IIT OR APPLICATION NO; 5899 <br /> <br />CONTRACTOR, NO. 40298 <br />LICENSE NO: <br />GRISWOLD ELECTRIC <br />22856 JENNIE RD <br />LYONS, OREGON <br />PHONEs 859-2246 <br /> <br />~JPERVISIN6 ELECTRICIAN/NUNBER <br />N J GRIE~OLD <br /> <br /> ITEM <br />NOSILE HONE CONNECTION <br />FLEET SURCHARGE -ZONE 3 <br />ELECTRICAL STATE SURCHARGE <br /> <br />~UANTITY ANOUNT <br /> t $20.00 <br /> $3.84 <br /> $~.0o <br /> <br />$24,84 <br />$0~00 <br /> <br />$0 <br /> <br />PAYEE: GRISADLD ELECTRIC RECEIPT NO.' 6468 <br />RECEIVED BY.* cl .., . :~PE'~ CK== CHECK ~** 8828 <br /> <br />R~R~: ~8453 ~ ~ <br /> <br />DmALD E. ~DLEY, ~R[~ ~NW, ~. <br /> <br />FOI~M ¢~ MC` I~'1'~[ REV, e/e~ OF FICE COPY <br /> <br /> <br />