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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 />I al'h poffOrlfllfl(J work on a pfoport~ I O¢~r~ Or OCCupy <br />I am a refpstered builder OR ( / the authorized representative SIGNATURE OF APPLICA ~ <br />of ~ registered builder <br /> .., <br /> <br />OWN~;~JE: 09/19/90 ]1¢4E: 12:18:48 <br /> <br />qlTHS ^nBnES¢IACK:3''C¢4' JOE B. &MILDREO <br /> <br />TAX LOT <br /> <br />CONSTRUCTION ~YP~ <br /> <br />CATEGORY <br /> <br />OCCUPANCY <br /> <br />DEN l i AL <br /> <br /> 8601 HOMOuI~I' RD <br />AUfv~VILLE <br />USE OF BUILOINO <br /> <br />SE <br /> <br />CONTRACT CITY UG~ <br />P4AR I f.)N COUNt' Y NO <br /> <br /> PO BOX 1187 <br /> AUf4SViLLE OR 97325 <br /> PHONB: <br />LOT BLOCK 8EC¢ION TOWNSHIP <br /> <br />R^NG~ALUAFION: ZONE <br /> <br /> DEPTH AREA ~71 UNITS <br />2?2 100 27200. <br /> <br />~ IYPE: ~LECIRIUAL PgR~II OR APPLiCAIION NO: 9027381 <br /> <br />CONtRACtOR, NO. <br />LIC~N~g NO: <br />JACk, JOE 8. & NiLORED <br />PO ~OX 118'/ <br />AUNSVILLE OR 9?325 <br />PHONEt 749-2227 <br /> <br />SUPERVISING ELECfRICIAN/NUr'4B~R <br /> <br />~tANUFACfURED HOC4E SERVICB/FBEDgR <br />PLB~I ~UR~AN'GB -ZONE <br />ELECtRiCAL SfAf~ ~AJROHARG~ <br /> <br /> QUANIiIY AMOUNI <br /> 3 $35.00 <br />a $3,84 <br />~ $1.75 <br /> <br />'iOIAL 8ES~60 <br />PR~¥iOUS RECEIPTS <br /> <br />$40.59 <br /> <br />$40.59 <br /> <br />BALANCE DUE $0.90 <br /> <br /> ~ RECEiPI NO: 289bg <br />'tYPE; CK CHECK ~: ?4? <br /> <br />PAYEE: JACKbON, JO~ <br />RECEIVED BY; Pt¢ ......................................................,~,~,.,~, <br /> <br />~ THIS IS NOT A PERRJ. T. THI~ APPLJ. CATJON r~T EO THROLE~ A REVIEW PROCESS I,~-IERE THE <br />FOLLOI~.[N~i I~IUST RE COI~c~_ETED. IT IS THE RESP~t~IBJ. LiTY OF THE APPLICANT TO ~RE THAT <br />ALL NECESSARY INI~ORr4ATION HAS BEE~ PI~OVIDED~ <br /> <br />PL,,~'4 RE¥18W: ~Y <br /> <br />Rk'hl, ARKS: CONN R~2906 <br /> <br />DATE <br /> <br />CiTY JURiSOiC[ION: BY 0ArE <br /> <br />OFFICECOPY <br /> <br /> <br />