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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-?904 <br /> <br /> Other <br /> <br />DATE: 09/12/90 TII~IE~ 10;18.'16 <br /> <br /> BANDY, RICHARD <br /> <br />SIGNATURE OF APPLICANT~ <br /> DATE: <br /> <br />TAX LOT: <br />cONBTRBCTION TYPE: <br /> <br />RE$i DF_~I' lab <br /> <br /> 9194 SHAW S(~ARE RD SE <br />/t,J. JIVlSVi LLE OR 9'13,25 <br /> <br />USE OF BUILDING; <br /> <br /> CONTRACT CrTY: : UGB: <br />,,I~IARION COUNTY ~ NO <br /> <br />OCCUPANT LOAD: <br /> <br />LOT: BLOCK: : SECTION: ~ ~OWN$BIP; <br /> <br /> ~iI'E NUI'*IBER: 7553 <br /> VALUAT ION: <br /> <br /> RANGE: : ZONE: <br /> 85 2W AR <br />AC ,,~. LOT: NO coRN~ <br /> <br />MAP: <br /> <br />49 <br /> <br />TYPE: ELECTRICAL PERffiIT OR APPLiCATICN NO; <br /> <br />27174 <br /> <br />C,'.,'.,'.,'.,'.,~N T P-.AC T OR. NO. 626&5 <br />L i CF.~NSE NO: <br />BREAKER ELECTRIC <br />6501 BROOKLAKE RD NE <br />~, ORE~ 97305 <br />~E: 393-0311 <br /> <br />SUPERV [SIN6 EL.roTC T R i C I AN/NUN~ ER <br />JEFF BROWN iAK <br /> <br /> 1 I'EJ~I <br />RES NIRING < 2000 ,S~ FT <br />TNO OR I~ORE NEW CiRCUiTS;ALT OR EXI' <br />FLEET ,$LIRCHAR6E -ZONE 3 <br />ELECTRICAL STATE SURCHARGE <br /> <br />(.~AN'f' 1'i'Y ANOUN'I' <br />1 <br />1 $30. oD <br /> <br /> $5.25 <br /> <br />TOTAL A,.'5~ES'~ED :FEES <br />PREVIOUS RECEIPTS <br />THiS RECEIPT <br /> <br />$114.09 <br /> $0.00 <br />$114_09 <br /> <br />BALANCE DOE <br /> <br /> PAYEE: BREAKER ELECTRIC RECEIP'¥ NO: 28?64 <br /> RECEIVED BY: D("4 TYPE= OK CHECK ~.* 5022 <br /> <br /> ~ 3HIS IS A VALID PET~IT :~ THIS PEI~IT ~I~ 180 ~::F~ <br />~T~Z~ ~ ~ A ERI~ OF 180: ~, ~ IF ~T~Ti~ FAI~ <br /> <br /> NU~ ~O <br /> <br />REIV~RK,S: RES NIRiNG ~ 1 CiR FOR GARAGE/1CIR TO BARN R~3816 % <br />D(~ALD E. WC.'~DLE~, I~,.RiON COUNTY BUILDING OFFICIAL / BY .................. ~~ ....................... <br /> <br />OFFICE COPY <br /> <br /> <br />