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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. ,~O. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 585-514T <br />CODE-A-PHONE 4:30 P.M. - 8:00 A.M, <br /> <br /> I am performing work or3 a property { own or occupy. <br /> lam a registered builder OR( )lheauthorized representative <br /> of a registered builder, <br /> The work will be performed by a registered builder. <br /> Other <br /> ) have read and agree to the terms slated on the reverse s~de o~ <br /> fbi8 document. <br /> <br />OATE: 12/08/89 Tt'ME: 18:09t57 <br />OWNER: <br /> DAVIS, D/~IAL <br /> <br />SITUS ADDRESS: <br /> <br /> 11041ARNDT RD NE <br />AURORA OR 97002 <br /> <br /> USE OP 8UILOINC: <br /> <br />' M,~ILING ADoREss: <br /> <br />E~4E <br />678-1056 <br />PHONE: <br /> <br /> C0NSTRUCTIOA T~PEz <br /> <br />CONTRACT CITY; 10~~a: <br />I~RION COJNTY ! NO <br /> <br /> CATEGORY: <br /> RESIDENTZAL <br /> <br />;OCCUPANCY: <br /> <br />OCCUPANT LOAD: <br /> <br /> SITE NU~IBER: 8564 <br /> VALUATION: <br /> <br />;~EC~ioN: ' TOWNSHIP; i ~N~S: ZONE: <br /> <br />MAP: <br /> <br />ELECTRICAL <br /> <br />CONTRACTOR, NO. <br />LICENSE NO: <br />BEAR ELECTRIC, INC. <br />PO BOX 3~9 20985 BUTTEVILLE RD <br />DONALD, ORF_~ON 97020 <br />PHONE: 678-1955 <br /> <br /> PERNIT OR APPLICATION NO: 20702 <br /> <br />20919 ~UPERVISiNG ELECTRIClAN/NUN~ER <br /> GORDCN LENONS : 27348 <br /> <br />TOTAL ~=SE0 FEES <br />PREVIOUS RECEIPTS <br />THIS:RECEiPT <br /> <br /> ITEM <br />ONE NENSlt~NOH CIECUITpALTER OR EXTEND <br />FLEET E~JECHARGE -ZONE 6 <br />ELECTRICAL STATE SURCHARGE <br /> <br />qUANTITY <br /> 1 <br /> <br />A~DUNT <br /> $20.00 <br /> $7.58 <br /> $1.00 <br /> <br />$28.68 <br /> $0.00 <br />$28.68 <br /> <br />$0.00 <br /> <br /> PAYEE: BEAR ELECTRIC, INC. RECEIPT NO: 21965 <br /> RECEIVED BY: ON TYPE: CK CHECK ~: 664? <br />~ THIS I~ A VALID PF-R~IT ~ THI~ PEI~IT :EXPIRI~ 180 :DAY~ FRC~'"I'T~ ISSUE DATE, IF <br />C~NSTRUCTION CEASE~ FOR A PER,OD OF 180 ~, ~ IF ~i~ FAI~ TO ~ ALL <br /> <br />~ALL B~ ~LL ~D ~D. <br /> <br />RF. NARKS= 1CIR R~2519 <br /> <br />DONALD E. NOODLEY, NARION COUNTY 8UILDIN0 OFFICIAL / BY <br /> <br />OFFICE COPY <br /> <br /> <br />