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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG NO 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 9'7301 <br /> <br /> PHONE: 588-5147 8.00 - 4::30 <br />24 HOUR CODE-A-PHONE:: 588-7904 <br /> <br />I ha~e read and agree to the terms stated on the reverse side of <br /> <br />10/09/90 riME: 12:04:59 <br /> <br /> 8601 HOIv~UISf RD <br /> AU~oV i LLE <br />USE OF BUILDING <br /> <br />MAILING ADDRES~ <br /> <br />OR 9?325 <br /> <br />5E <br /> <br /> TAX LOT <br /> <br /> CONSTRUCTION TYPE <br /> <br />MARION COUN I Y <br /> <br />NO <br /> <br />OCCUP^NCV RE~iDEN f IAI... <br /> <br /> PO BOX I 187 <br /> AU~.ViLLE OR 9?325 <br /> PHON~": 749-2227 <br />LOI BLOCK <br /> <br />SECTION TOWNSHIP <br /> <br />Si~E NUMEtER: 4284 <br />R^N~i,~.L.UA f' Ib~: ZONE <br /> <br />WIDTH <br /> <br /> DEPTH AREA ~1 UNITS <br />272 100 27200. <br /> <br />LOT 1~ CORNER AR <br /> NO NO <br /> <br />48 <br /> <br />lYRE: ELEC]RiCAL PEI~4i] OR APPLICA]ION NO: <br /> <br />27361 <br /> <br />CONfRACFOR, NO. <br />LICENSE NO: <br />JAC~N, dO~ Et. & NILORE0 <br />~J EtOX 1187 <br />AU~ViLt. E OR 97325 <br />PHONE: 749~222't <br /> <br />~J~UPERVISiNG ELECIRICIAN/NUM~R <br /> <br />NANUFAC'fUREO HGfflE SERVICE/FEEDER <br />ELECfRZCAL SfAFE SURCHARGE <br /> <br />OUANfifY AMOUNf <br /> 1 $38_00 <br /> $3.84 <br /> $1_75 <br /> <br />TOIAL ASSESSED PEE5 <br />IHiS RECelPf <br /> <br />$40+59 <br />$40. b9 <br /> $0.80 <br /> <br />PAYEE: <br />REtCEiVEO BY: CL <br /> <br />EtALANCE 0~E $0_00 <br /> <br />RBCEiPI NO: <br />CHECK <br /> <br />lYRE: 0 <br /> <br />* THiS i$ A VALID PER~Ii'f ~ 1Hi~ PE~IlT EXPiRE~ 180 DAY~ ERC~ ITS I~E DAI6. iF <br />OONS'IR~CTION C~..~ FOR A PERIOD OF 180 DAY~, OR [E CONSTRUCTiON FAILS 10 MEET ALL <br />REL~UJRE~ENTS OF STATE LAA~ AND NARION COJNTY BUILDING AND ZONING ORDINANCES, THIS PERi, iT <br />SHALL EtEC:O~E NULL ANO VO[D. <br /> <br />REf4ARK5: CXjNN R~2906 <br /> <br />(~JN&LD E. I,~JODLEY. MARION COUNIY BUILDING OPEiCiAL / BY ~ <br /> <br />OFFICE COPY <br /> <br /> <br />