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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO 225 <br />220 HIGH STREET NE <br /> SALEM. OREGON 97301 <br /> <br /> Plff~D N E ~'88-5147 <br />CODE-A-PHONE 4::30 PM - 8::00 AM <br /> <br />I ha~e read and agree to the terms stated on the reverse side of <br />fh~s document <br /> <br />SIGNATSRE OF APPLICANT <br /> DAT'E <br /> <br />~F~: 12/28/89 <br />situs ADDI~(~AN, TOM <br /> <br />TIME: 14:51:58 <br /> <br />TAX LOT <br /> <br />CONSTRUCTION ry~.0048-360 <br /> <br />CATEGORY <br /> <br />OCCUPANCY RESIDENTZAL <br /> <br />895 8TH <br /> <br /> CONTRACT CITY UGB <br /> <br />AUMSVILLE NO <br /> <br />OCCUPANt LOAD <br /> <br /> NO OF BED~OOM5 <br /> <br />SUBDIVISION <br /> <br />PO Box 185 <br />SUBLIMITY OR 9?385 <br /> F~4ONE: 769-7384 <br />LOI BLOCK <br /> <br />SECTION TOWNSHIP <br /> <br /> DELMAR III <br /> <br />SITE NUMBER: 892? <br />mCA~DATION: ZONE <br /> <br />MAP <br /> <br />WIDTt'l~ 3 <br /> <br />DE PTI.I 5 AREA 25 UNITS 8S <br /> 100 ?400+ OF <br /> <br />IRBEG LOT2w CORNER <br /> <br />51 <br /> <br />TYPE: ELECTRICAL PERMIT OR APPLICATION <br /> <br />21024 <br /> <br />CONTRACTOR, NO. 20?5 <br />LICENSE NO: <br />NORTHSIDE ELECTRIC INC <br />PO BOX 7124 <br />SALEM, OREGON 9?303 <br />PHONE: 893-5559 <br /> <br />SUPERVISING ELECTRICIAN/NUiV~ER <br />ARLIN E. ADArCC:c3N /147§S <br /> <br /> ITEM <br />RF~ WIRING < 2000 SO FT <br />FLEET SURCHARGE wZONE 3 <br />ELECTRICAL S'FATE B~JRCHARBE <br /> <br />QUANTITY ANOUNT <br /> $75.00 <br /> $3.84 <br /> 3.75 <br /> <br />TOTAL ASSESSED FEES <br />PREVIOOS RECEIPTS <br />THIS RECEIPT <br /> <br />$82.59 <br /> $0.00 <br />$82.59 <br /> <br />BALANCE DUE $0.00 <br /> <br /> PAYEE: NORTHSIDE ELECTRIC INC RECEIPT NO: 22305 <br /> RECEIVED BY: PS TYPE: OK CHECK ~: 7314 <br /> <br />~ THIS IS A VALID PEF~IT * THIS PERMIT EXPIRB 180 DAY~ FROM I~ I~E ~TE. IF <br />~ST~OTI~ O~ FOR A PERIOD OF 180 ~, OR IF ~ST~OTI~ FAI~ TO M~'i ALL <br />R~TS OF ~TATE ~ ~D ~RI~ ~N~ BU~LDIN~ ~D Z~ING ORBIN~O~, ~IS PE~IT <br />~ALL BEdE NULL ~B <br /> <br />RErC~RKS: RES R~0428 <br /> <br />DONALD E. ~¢3ODLEY, MARION COUNTY BUILDING OFFICIAL / BY <br /> <br />F'OnM ,, MC I:'-, Fd.~ t¢'~' OFFICE COPY <br /> <br /> <br />