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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-PHON~ 4::30 PM - 8::00 AM <br /> <br />f ha~e read and agree to the terms stated on the reverse s~de of <br /> <br />SIGNATURE OF APPLICANT <br /> DATE <br /> <br />~Y'ANI~t~: 12/28/89 <br />snus AOO~NN, TOM <br /> <br />TIME: 14:45:23 <br /> <br />TAX LOT <br /> <br />CONSTRUCTION TyP~O040--328 <br /> <br />OCCUPANCY RESIDENTIAL <br /> <br /> CONTRACT CITY UGB <br />855 8TH <br />AUMSVI LLE OR 9?325 <br />USE OF BUILDING AUI'4SvI LLE NO <br /> <br />OCCUPANT L CAD <br /> <br /> NO OF BEUROOM$ <br /> <br /> DELMAR III <br />PO BOX 185 <br />SUBLIMITY OR 97385 <br />PHONE: 769-7364 SITE NUIVBER: <br />LOT BLOCK SECTION TOWNSHIP ¢¢AIi~JAT I ON: ZONE <br /> <br />8926 <br /> <br />MAp¸ <br /> <br />WIDTH19 DEPTH 6 AREA 25 UNITS 8S IRREG LOT2w CORNER <br /> 75 I ¢~ '~500. ~F ,NO <br /> <br />TYPE: ELECTRICAL <br /> <br />CONTRACTOR, NO. 2075 <br />LICENSE NOt <br />NORTHSIDE ELECTRIC INC <br />PO BOX 7124 <br />SALEM, OREGON 97303 <br />PHONE: 393-5559 <br /> <br />PERMIT OR APPLICATION NOt 21033 <br /> <br /> SUPERVISING ELECTRICIAN/NUMBER <br /> ARLIN E. ABANDON /1479S <br /> <br /> ITEM <br />RES NIRING< 2000 SQFT <br />FLEET SURCHARGE -ZONE 3 <br />ELECTRICAL STATE SURCHARGE <br /> <br />PAYEE: NORTHSIDE ELECTRIC INC <br /> <br />QUANTITY AMOUNT <br /> 1 $75.00 <br /> ~3.84 <br /> 3.75 <br /> <br />TOTAL AZS. ESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />$82.59 <br /> $o.oo <br />$82.59 <br /> <br />BALANCE CUE $0.00 <br /> <br />RECEIPT NO: <br /> <br /> 22304 <br /> RECEIVED BY: PB TYPE: CK CHECK ~; 0 <br /> * THIS I8 A VALID PERMIT * THIS PERMIT EXPIRES 180 BAYS FRO~I ITS ISSUE BATE. IF <br />CONSTRUCTION CF_.A~I=~ FOR A PERIOD OF 180 DAYS, OR IF CONSTRUCTION FAILS TO NEET ALL <br />~HQUIRE~ENTSOF STATE L~ANDNARION COUNTY BUILDINGAND ZONING ORDINANCES, THIS PERMIT <br /> ALL BEC~E NULL ANDVOIO. <br /> <br />REMARKS= RES R~0438 <br /> <br />DONALD E. NOODLEY, MARION COUNTY BUILDING OFFICIAL / BY <br /> <br />OFFICE COPY <br /> <br /> <br />