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MARION COUNTY BUILDING INSPECTION <br /> SENATOR BL?~'~. N~225 <br /> 220 HIGH <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> I am performmg work on a property I own or occupy. . <br /> [~lmaregistered builder OR( )theauthorizedrepresentatlve <br /> of 8 registered builder, <br /> The work wdl bo performed by a registered builder. <br /> Other <br /> I have read add agree to the terms stated on the reverse side of <br /> <br /> DALE: 0:3/05/9t f' I lYrE_' 9:4,4:07 <br /> <br />OWNER 'SELDEN, BEN <br /> <br /> 120~5 BELOEN OR <br />Aur'4~ViLLE <br /> <br />OR 97325 <br /> <br />USE OF SUILDING~ <br />'MAILINO ADDRESS: <br /> <br /> PHONE: ?69-552')' <br /> <br />I'.f~.RiON 6.'OUN'I Y NO <br /> <br /> SiTE NUfflBER: ?706 <br /> VALUA'F i ON: <br /> <br />CATEGORY: <br /> RESI DEb, <br /> <br />OCCUPANCY <br /> <br />OCCUPANT LOAD: <br /> <br /> NC 0¢ BEDROOMS <br /> <br />SECTION: TO~NNSHIF RANG~ ZONE <br /> 2W <br /> <br /> MAP <br />EFU '54 <br /> <br />TYPE: ELECTRICAL <br /> <br />CONTRACTOR, NO- 10875 <br />LICENSE NO; <br />CHERRY Ct'fY ELEC <br />PO BOX 12668 <br />SALEI~I ORE 97309-0668 <br />PHONE: 399-?609 <br /> <br />PERI~41¥ OR APPLiCA'T'iON NO: 30735 <br /> <br /> SUPERVISING ELECTRiCiAN/NUMBER <br /> JCN J ~¢OLF <br /> <br /> i'f'E~ <br />SERViCE/FEEOER 101 'FO 400 AMPS <br />ELECTRICAL STATE SURCHARGE <br /> <br />QUANIII'I'y ,,~,j~UN'lI <br /> 1 $6o.oo <br /> $3, gO <br /> <br />TOTAL ~ED FEES <br />PRS¥1OUSRECEiP'fS <br />THiS RECEIPT <br /> <br />$63.00 <br /> $o.oo <br />$53,00 <br /> <br />BALANCE OUE $0.00 <br /> <br /> PAYEE: CHERRY CiTY ELEC RECEIPT NO: 324,6? <br /> RECEIVED BY: 01'42 TYPE: CK CHECK ~: 21470 <br /> <br />* THIS iS A VALID PERI, iT *: THIS. PER,lIT EXPiR~ 180 ~ F~ iTS i~E ~T'E. IF <br />~ST~OTZ~ C~ ~R A PERIOD OF 180 ~, OR IF ~8T~CTi~ FAI~ TO .EET ALL <br />~~B ~L~T~ ~.~O ~RZ~ ~NTY BUILDING ~O Z~[Ne ORDiN~C~. THIS PE~IT <br /> <br />REMARKS: NEW SERV R~5985 <br /> <br />DONALD E. NCYODLEY, MARION COUN'¥Y BUiLDiNG OFFICIAL / BY <br /> <br />FORM # MC 15-56 R~V, 4/t~ 0~ C E COPY <br /> <br /> <br />