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220 HIGH STREET NE <br />SALEM, OREGON 97301 <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONE 4:80 P.M. - 8:00 A.M. <br /> <br />Other <br /> <br />I have read and agree to the terms stated on the reverse side of <br /> <br />SI~NATUFIE OF APPLICANT: <br /> OATS; <br /> <br />o¢)A4'$: 07/14/88 TIME: 10~4B:SBa <br /> <br /> SPARKS, BRAIN <br />SITUS ADDRESS' <br /> <br />TAX LOT <br /> <br />CONSTRUCTION TYPE <br /> <br /> 150 SANTIAM AVE <br />DETROIT <br /> <br />OR 97342 <br /> <br /> CONTRACT CITY. <br /> <br />DETROIT <br /> <br />MAILING ADDRESS: ------ <br /> <br />1220 MONMOUTH <br />INDPENDNECE, OREGON 97351 <br />PHONE: <br /> <br />LOf: RLOCK S~CTION' TOWNSHIP. <br />WIDTH 5 [)E PTR 9 AREA UNITS 10 <br /> 35 150 5250_0£ ........ %F <br /> <br />JGB: <br /> <br /> NO <br /> <br /> HAMMOND <br /> <br />SITE NUMBER: 4354 <br />VALUA'F]ON: <br />RANGE BONE <br /> <br /> RREG. LOT' ~E CORNER ~ <br /> NO · : ..... NO . <br /> <br />CATEGORY <br /> <br /> RESIDENTIAL <br />OCCUPANCY <br /> <br />~CCUPANT LOAE <br /> <br /> 'NO OF flFDROOMS <br /> <br />MAP: <br /> <br /> 1 O5 <br /> <br />TYPE: ELECTRICAL PERMIT OR APPLICATION NO: <br /> <br />9727 <br /> <br />CONTRACTOR NO. <br />_ICENSE NO: <br />SPARKS, BRAIN <br />1220 h4ON~)UTH ~39 <br />INDPENDNECE, OREGON 97351 <br />PHONE: <br /> <br />SUPERVISING ELECT'R I C IAN/NUMaER <br /> <br /> ITEM <br />MOBILE HOME SRACE (SVC EQUIP) <br />MOBILE ROME CONNECTION <br />FLEET SURCHARGE -ZONE ? <br />ELECTRICAL STATE SURCHARGE <br /> <br />OUANTITY AMOUNT <br />I $20.00 <br />1 $20,00 <br /> $8-96 <br /> $2_00 <br /> <br />;'TOTAL A,%SESSED FEE'S <br /> PREVZOUSRECEIPTS: <br /> THIS RECEIPT <br /> <br />$50.96 <br /> <br />$50.96 <br /> <br />BALANCE DUE $0.00 <br /> <br />PAYEE: SPARKS, BRAIN RECEIPT NO; 10405 <br />RECEIVED BYt >c<x - ~TYPE:~ CK CHECK ~: 2900 <br /> <br />* THIS IS A VALID PERMIT * THIS PE~IT EXPIRES 180 DAYS FRO~ ITS ISSUE DATE_ IF <br />CONSTRUCTION CEASES FOR A PERIOD OF 180DAYS;ORIPCONSTRUCTION FAILS TO MEET ALL <br />REQUIREMENTS OF STATE LAWS PC4D MARION:OOUNTYBUILDINGANDZONING ORDINANCES, THIS PE~4IT <br />SHALL 8EOOf4E NULL AND VOID. <br /> <br />REMARKS: NIH SERVICE & CON R~'~'t028 <br /> <br />DONALD E. NOODLEY, MARION COUNTY BUILDING OFFICIAL /BY <br /> <br />FCI~M I~ MO ~5'56 REV'6/~? OFFICE COPY <br /> <br /> <br />