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MARION COUNTY BUILDING INSPECTtON <br />SENATOR BLDG NO 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> P~ONE 588-5147 <br /> CODE-A-PHONE4::30 PM -8::00AM <br /> <br />I am performing work on a property I own or occupy <br />lamareOlstofodbudderOR( )theauthorizedrepresentatNe <br />of a reg*stered builder, <br />The work wdl be performed b'y a registered builder <br />Otbor <br /> <br />SIGNATURE OF APPLICANT <br /> DATE <br /> <br />BORAN, TON <br /> <br />TIME: 10:38:15 <br /> <br /> TAX LOT CATEGORY <br /> <br /> 90061-321 <br />CONSTRUCTION TYPE OCCURANCY <br /> <br />RESIDENTIAL <br /> <br />990 CHERYL __ CONTRACT CITy UGO OCCUPANT LOAD <br />AUMSVI LLE OR 9'7328 <br />usc 0¢ BU. DiNG AUMSVILLE NO .0 oF B£DR00MS <br /> <br />PO BOX 185 <br />SUBLIMITY OR 97325 <br />PHONE: 769-?364 <br /> <br />LOT BLOCK SECt'ION TOWNSHIP <br /> 8 4 25 8S <br /> 83 98 SF <br /> <br />GILDON II <br /> <br />SITE NUMBER: 8510 <br />VALUATION: <br />RANGE ZONE <br /> <br />YES YES <br /> <br />TYPE: ELECTRICAL PERMIT OR APPLICATION NO: <br /> <br />20549 <br /> <br />CONTRACTOR, NO. 2075 <br />LICENSE NO: <br />NORTHSIDE ELECTRIC INC <br />PO BOX 7124 <br />SALEM, OREGON 97303 <br />PHONE: 393-5559 <br /> <br />E~JPERVISING ELECTRICIAN/NUMBER <br />ARLIN E. ABAI'¢~ /1479S <br /> <br /> ITEM <br />RES WIRING < 2000 SQ FT <br />FLEET SURCHARGE -ZONE 3 <br />ELECTRICAL STATE SURCHARGE <br /> <br />OUANTITY AMOUNT <br /> 1 $75.00 <br /> $3.84 <br /> $3.75 <br /> <br />TOTAL AE~F_.SSED FEES <br />PREVIOUS 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: 21805 <br /> RECEIVED BY; PB ,,, TYPE: CK CHECK ~: ?829 <br />~ THIS IS A VALID PEF~IIT $ THIS PERMIT EXPIRES 188 DAYS FROD1 ITS [,%.SUE DATE. IF <br />CONSTRUCT]ON CEASES FOR A PERIOD OF 188 DAYS, OR IF CONSTRUCTION FAILS TO MEET ALL <br />REQUIREMENTS OF STATE LAt~ AND MARION COUNTY BUILDING AND ZONING ORDINANCES, THIS PE~IIT <br />SHALL 8ECO~IE NULL AND VOID. <br /> <br />REI'4ARKS: RES F~t8346 <br /> <br />DONALD E. WOODLEY, MARION COUNTY BUILDING OFFICIAL / BY <br /> <br />:OhM ,, MC ,~, ~: H~ ,~,~, OFFICE COPY <br /> <br /> <br />