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MARION COUNTY BUILDING INSPECTION <br />SENATORBLDG NC)225 <br />220 HIGH S"TREE'~ NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONE 4::30 P.M - 8::00 AM <br /> <br />of 8 re§istere¢ builder <br />The work will be performed by a registered builder <br />Other, <br /> <br />S~TUS ,Dd~;~AN, TOM <br /> <br />TIME: 7:52:55 <br /> <br />SIGNATURE OF APPLICANT <br /> DATE <br /> <br /> TAX LOT <br /> <br /> OONSTRUCTfON TY~040~080 <br /> <br />CATEGORY <br /> <br />OCCUPANCY RESIDENTIAL <br /> <br />885 9TH ST <br /> <br />0R973~5 <br /> <br /> CONTRACT CITY UGB <br />AUMSVILLE NO <br /> <br />OCCUPANT LOAD <br /> <br /> NO 0~ 8EO~00MS <br /> <br />PO 80X 185 <br />SUBLIMITY OR 97385 <br />F:~40NE: 769-7364 <br /> LOT BLOCK <br /> <br /> DELMAR III <br /> <br /> SITE NUMBER: ?3?7 <br />SECTION TOWNSHIP YA'I~tCAT I ON: ZONE <br /> <br />MAP <br /> <br />WlDT~ <br /> <br />DEPTH~ <br /> <br />AREA 2~' UNITS 8S IRREG LODw CORNBR <br /> <br />51 <br /> <br />TYPE: ELECTRICAL <br /> <br />CONTRACTOR, NO. 20?5 <br />LICENSE NO: <br />NORTHSIDE ELECTRIC INC <br />PO 8OX 7124 <br />SALEM, OREGON 9?303 <br />PHONE: 393-5559 <br /> <br /> ~ ITEM <br />RES WIRING < 2000 SO FT <br />FLEET SURCHARGE -ZONE 3 <br />ELECTRICAL STATE SURCHARGE <br /> <br />PAYEE= NORTHSIDE ELECTRIC INS <br /> <br />PEF~IIT OR APPLICATION NO; 21439 <br /> <br /> SUPERVISING ELECTRICIAN/NUMBER <br /> ARLIN E. ADAMSO~ /1479S <br /> <br />QUANTITY AMOUNT <br /> 1 $?5.00 <br /> $3.84 <br /> $3.75 <br /> <br />TOTAL A,.%SESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />$82~59 <br /> $0.00 <br />$82.59 <br /> <br />BALANCE BUR $0.00 <br /> <br />RECEIPT NO: <br /> <br /> 22739 <br /> RECEIVED BY: IDN TYPE: CK CHECK ~¢: ?994 <br /> ~ THIS iS A VALID PER,lIT ~ THIS PER~IT EXPIRES 1BO DAYS FT~f4 ITS I,.S.gJE DATE. IF <br />O3NSTRUCTION CEAS.~k"~=[ FOR A PERIOD OF 180 DAYS,. OR IF C~t*I~I~&JCTION FAILS TO M~'m ALL <br />~ALIRENENTS OF STATE ~ AND MARION COUNTY BUILDING AND ZONIN~ ORDINANCES. THIS ~IT <br /> L 8EOO~E NULL AND VOID. <br /> <br />REfVI~RKS: NE~ RES R~2625 <br /> <br />DONALD E. ~¢DODLEY, fCC, RION COUNTY BUILDING OFFICIAL / BY <br /> <br />OFFICE COPY <br /> <br /> <br />