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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG..NO. 2¢,5 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONE 4:30 P.M, - 8:00 A.M, <br /> <br />I am performinc~ work on a property I own or occupy. <br />I af~ a registered bull?er OR the authorized representative <br /> of a registered build,r, <br />The work will be pedormed by a registered b¢lder, <br />Other_ <br /> <br />SIGNATUR~ OF APPLICANT: <br /> DATE: <br /> <br />o~Al~Ei 11/02/89 <br /> <br />SITUS AOORE~J?ORE' .J.~F~ <br /> <br />1:02:25p <br /> <br />TAX LOT CATEGOR~ <br />CONSTRUCTION TYPE oDCgPANC <br /> <br />RESI DENT IAL <br /> <br /> 11980 FARGO RD <br /> AURORA <br />usB OF ~UlLDI~= <br /> <br />OR 97002 <br /> <br />NE <br /> <br /> CONTRAOT SIT1 UGg OOCUPANI' LOAD <br />N~RION COUNTY qO .o o~ <br /> <br />MAIUNG ADDRESS: <br /> <br />Sg gDIVl$1Ofl: <br /> <br /> SAME <br /> <br /> PHONE: <br /> <br />LOT: <br /> <br /> SITE NUMBER; 4752 <br /> BLOCK: SECTION: TOWNSHJP: MAp: <br /> <br /> DEPTH: AREA: 4 UNITS: 4S tRREG, LO~: 1N :CORN~: EFU 4 <br />125 225 28125.0 ~F NO NO : <br /> <br />TYPE: ELECTRICAL <br /> <br />CONTRACTOR, NO. 42047 <br />LICENSE NO: <br />TODD KENAGY ELECTRIC <br />111 NH 2ND STREET <br />CANDY. ORE~ 97013 <br />PHONE: 263-8828 <br /> <br />PERMIT OR APPLICATION NO: 18941 <br /> <br /> SUPERVISING ELECTRICIAN/NUMBER <br /> <br /> ITEN <br />C/I SERV 101-200 ANPS <br />FLEET SURCHARGE -ZONE 6 <br />ELECTRICAL STATE SURC...HARBE <br /> <br />PAYEE: <br /> <br />QUANTITY AMOUNT <br /> 1 $70.00 <br /> $7.68 <br /> $3.50 <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />$81.18 <br /> 81.18 <br /> $0.00 <br /> <br />BALANCE DUE $0.00 <br /> <br />RECEIPT NO: <br /> <br />RECEIVED DY: PR TYPE: CHECK <br />~ THIS I8 A VALID ~ERMIT · THIS PE~IT EXPIRES ]$~ BAY~ FRO~4 ITS I~E <br />~ST~TI~ C~ FOR A PERIOD Of 180 ~YS, OR If ~ST~CTI~ FAI~ TO ME~ ALL <br />~I~B~ OF STATE ~ ~D ~RI~ ~N~ BUILDING ~D Z~ING ORDIN~C~, ~IS PE~IT <br />~ALL B~E NULL ~D VOID. <br /> <br />RBVlARKS: 200 ANP SERV R~¢6080 ~~_ <br />DONALD E. NOODLEY, MARION C. OJNTY BUILDING OFFIC]:AL / By <br /> <br />OFFICE COPY <br /> <br /> <br />