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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 888-5147 <br />CODE-A-PHONE 4::30 PM - 8::00 AM <br /> <br />lamaregratered builder ORI } the authorized represent:~ti~e <br />The work ¢~dl be performed by a registered builder <br /> <br /> I have read and agree to the terms stated on the rever~e side of <br /> <br /> DATE: 04/12/88 TIME: <br /> <br /> MARION COUNTY HOUSING AUTHORITY <br /> <br />SITUS AOORESS <br /> <br />SIGNATURE OK APPLICANT <br /> DATE <br /> <br /> TAX LOT <br /> <br /> CONSTRUCTION TYPE <br /> <br /> 7872 TERRANCE LANE SE <br />&UMSVILLE OR 97325 <br /> <br />USE OF BUILDIN~ <br /> <br />M4RTON CO~JNTY ,, NO <br /> <br />SUBDIVISION <br /> <br />CATEGORY <br /> <br />OCCUP~,NCY <br /> <br />~1ONE;, :390~0500 <br /> <br />25 <br /> <br /> SiTE NUMBER: ~...-{.4_.~ <br /> VALUATION: <br /> <br />85 2~v AR <br /> NO NO <br /> <br />TYPE* ELECTRICAL <br /> <br />CONTRACTOR, NO <br />LICENSE NO- <br />JUDSON'S iNC <br />PO SOX 12659 <br />SALEM. OR 9?309 <br />PHONE: 383..4!4 I <br /> <br /> PERMIT OR APPLICATION NO: <br /> <br />34604 SUPERVISING ELECTRIC~AN/NU~48ER <br /> DONALB N, KLtHL/1359 <br /> <br /> ITEM <br />SERV CHANGE ONLY.*EXISTING RESIDENCE <br />FLEE7 SURCHARGE -ZONE 3 <br />ELECTRICAL ST&TE SURCHARGE <br /> <br />QUAN'~ITY AMOUNT <br /> $20.90 <br /> <br /> $1.00 <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECeIPtS <br />THIS RECEIPT <br /> <br />$24,84 <br /> <br />$24- 34 <br /> <br />BALANCE DUE $0,00 <br /> <br />PAYEE; JUDSON'S INC RECEIPT NOt 8432 <br />RECEIVED BY; JB ................................. TYPE: CK CHECK ~: 2050 <br /> <br />~ THIS IS A VALID PEI~4IT * THIS PER~IT EXPIRES 180 DAYS FROI~ ITS ISDUE DATE. IF <br />CONSTRUCTION CEASES FOR A PERIOD OF 180 DAYS, OR IF CONSTRUCTION PAILS TO MEET ALL <br />REQUIREMENTS OF STATE LA~SAND f,!ARION COUNTY BUILDING AND ZONING ORDINANCES, THIS PE~DIlT <br />SHALL BECC~4E NULL AND VOID. <br /> <br />REMARKS: SERV.CHG_ R:'~9668 JUOSON*S <br /> <br />30NALD E_ ~OOOLEY, MARION COUNTY BUILDING OFFICIAL / BY ...... <br /> <br />ro~M ', MC ,;,,~t~ Rev 6,87 OFFICE COPY <br /> <br /> <br />