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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 <br />CODE-A-PHONE 4:30 RM. - 8;00 A,M. <br /> <br /> I have read and 8~roo to the terms 5tared on the reverse side of <br /> this document. <br /> <br />DATE; 08/08/89 TIME: 11:18:00a <br /> DORAN, TOM <br /> <br /> SIGNATDR~ O¢ APPLICANT: -. <br /> DATE: . <br /> <br />TAX LOT: <br /> 90061-461 <br /> <br />CATEGORY: <br /> RES I DENT i ~_~, <br />OCCUPANCY: <br /> <br /> 910 HAZEL <br />AUMSVILLE OR 97325 <br /> <br />CONTRAC~ CrTY: UGB: OCCUPANT LOAD: <br />AUMSVI LLE NO <br /> NO. OF BEDROOMS <br /> <br />P~ 8Ox 185 <br />,SUBLIMITY OR 97385 <br />PHONE: 769-7364 <br /> <br />10 5 <br /> 70 116 <br /> <br />GILDON I I <br /> <br /> SITE NUMBER: 7678 <br /> VALUATiONs <br /> <br /> 25 83 2W RI 51 <br />8120.00 SF NO NO <br /> <br />ELECTRICAL <br /> <br />CONTRACTOR, NO_ 2075 <br />LICENSE NO: <br />NORTHSIOE ELECTRIC INC <br />PO BOX 7124 <br />SALEM, OREGON 9?803 <br />PHONE: 393-~569 <br /> <br />PERMIT OR APPLICATION NO: 17965 <br /> <br /> ,SUPERVISING ELECTRICIAN/NUMBeR <br /> ARLIN E. ADAMSON /14793 <br /> <br /> ITEM <br />RES WIRING < 2000 SQFT <br />FLEET SURCHARGE -ZONE 3 <br />ELECTRICAL STATE SU~7_.HARGE <br /> <br />PAYEE; NORTHSIDE ELECTRIG <br />RECEIVED BY: PR <br /> <br />* THIS I~ A VALID PERMIT <br />CONSTRUCTION CEASES <br />REQUIREMENTS OF STATE <br />,,~rlALL BECOME NULL AND <br /> <br />QUANTI%Y AMOUNT <br /> $75.80 <br /> $3.84 <br /> $:3,75 <br /> <br />TOTAL ASS~ED FEES <br />'PREVIOUS,RECEIPTS <br />THIS'RECEIPT <br /> <br />$82.59 <br /> <br />$82.59 <br /> <br />8ALANC_.,E,:DLIE $0.00 <br /> <br />NO: 19072 <br />CHECK ~: 7525 <br /> <br />~IT,S I~E DATE+ IF <br /> FAIL.~ TO MEET ALL <br /> ORDINANCES. THIS PERMIT <br /> <br />OFFICE COPY <br /> <br /> <br />