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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH_.STREET NE <br /> SAL~"M, OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 -4:30 <br /> 24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am performing work on 8 property I own or occupy. <br />I am a registered buflder OR the authorized representative SIGNATURE OF APPLIOAN'r; <br />Of a registered builder, <br />The work will be performed by a registered builder. <br />Of her <br />I have read and agree to the terms Stated on the reverse side of DATE: <br />this document. <br /> <br />OwNl~)~.'f'E: 02/07/91 i'fME: 15+'15:08 :TAX LOT: <br /> OSLiE, STEVE [ RESIDENTIAL <br /> S[~US ADDRESS: CONSTRUCTION TYPE: <br /> <br /> 655 N 4TH S'f' ~ CONTRACT CITY: <br /> AU~ISVI LLE OR 97325 <br /> USE OF BUILDING: AU~ViLUE " <br /> <br />MAILING ADDRESS: .... SUBDWISION: <br /> <br />LUCA~ ADOi '[ ~,ON ........ <br /> <br />P.O. BOX 577 <br />AUIv~v I LLE <br />PHONE: 74-9-1290 Si fE NUIV~ER: 4892 <br /> VALUA'f i ON: ~ <br />LOT; 8LOCK; SECTION: ; TOWNSHIP: RANGE: ZONE~ T <br /> 4 t 2& 8~ 2~ ~ 5~ <br /> 80 150; 12000. SF NO ' NO <br /> <br />'fYPE: ELECTRICAL <br /> <br />CONTRACTOR, NO. <br />LICENSE NO: <br />QSLIE, Si'EVE <br />P.O. 8OX 57? <br />AUiY~VILLE <br />PHONE; 749-1290 <br /> <br />PERMIT OR APPLICAl'iON NO; 30257 <br /> <br /> SUPERVISING ELECTRiCIAN/NUMBER <br /> <br /> If'EM <br />~ERViCE/FEEDER q01 'ro &oo AMP~ <br />EI_EC'f'RZCAL STAfE SURCHARGE <br /> <br />PAYEE: <br /> <br />TOIAL ~ES,~EO FEES <br />PREVIOU~ RECEIPTS <br />THI~ RECE~P'f' <br /> <br />QUANI'iTY Ai'vlOUN'I' <br /> ~ $80_00 <br /> $2.0o <br /> <br />$63.00 <br /> $0.00 <br /> <br />BALANCE OUE $0.00 <br /> <br />RECE1P'f' NO: 31980 <br /> <br /> RECEIVED BY: DM TYPE: iN CHECK ~; 0 <br /> <br />* THiS iS A VALID PE~iT * THIS PERf4IT E XPIR~ 180 DA~ F~ iTS I,~E DATE+ tF <br />CONSTRUCTiON CE~ POR A PERIOD OF 180 ~, OR IF C~NGTR~JCTiON FALLS TO MEET ALL <br />RE.~XJIRERENTS OF STATE L~ AND MARiON CX3UNTY BUiLDiNG ~qD ZONING ORDINANCES, THiS PERf4iT <br />~HALL BEEZ3NE NULL AND VOID. <br /> <br />REMARKS; 200 AMP <br /> <br />DONALD E. NOODLEY, MARION COJNfY BUiLDiNG OF'F[CIAL / BY <br /> <br />~GR~ # MC ~ ~ REV..~,~ OFFICE COPY <br /> <br /> <br />