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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-PHONE 4::30 PM - 8::00 AM <br /> <br />SIGNATURE OF APPLICANT <br /> <br /> DATE ___ <br /> <br />owN~ATE: 08/0?/89 TINE: <br /> <br /> BERNING, BRETT <br /> <br />9:00:47a <br /> <br />TAX LOT <br /> <br />CONSTRUCTION TYPE <br /> <br />C~EGOR¢ <br /> <br />OCCUP&NCY <br /> <br />RESI DENT <br /> <br /> ?20 ~4ICHAEL HAY <br /> AUNSVf LLE <br />tJSF OF BUILDING <br /> <br />OR 97325 <br /> <br /> CONTRACT CITY <br /> <br />AUIv~VI LLE <br /> <br />UG8 <br /> <br />NO <br /> <br />~ 8OX 290 <br />AUNSVILLE OR 9?325 <br />PHONE: 749-2576 <br /> <br />LOT BLOCK SECTION TOWNSHIP <br /> <br /> PARCEL <br /> <br /> SITE NURSER: <br />RA~o~ALUATION:zoNs <br /> <br />8004 <br /> <br />MAP <br /> <br />167 <br /> <br />22O SF YES NO <br /> <br />51 <br /> <br />TYPE.' ELECTRICAL <br /> <br />CONTRACTOR, NO. <br />LICENSE NOt <br />8ERNING, 8RETT <br />PO 8OX 290 <br />AUNSVILLE OR 9?325 <br />PHONE: 749-2576 <br /> <br />PEF~'4IT OR APPLICATION NO: 17913 <br /> <br /> SUPERVISING ELECTRICIAN/NUIVrBER <br /> <br /> ITEN <br />TENP CONSTR SERVICE <br />FLEET SURCHARGE -ZONE 3 <br />ELECTRICAL STATE ,~AJRCHARGE <br /> <br />QUANTITY AMOUNT <br /> 1 $30.00 <br /> $3.84 <br /> $1_5o <br /> <br />TOTAL A.~.ESSED FEES <br />PREVIOUS RECEIPTS <br />THiS RECEIPT <br /> <br />~35.34 <br /> 35.34 <br /> $o.oo <br /> <br />BALANCE DUE $0.00 <br /> <br />PAYEE: RECEIPT NO: <br /> <br />RECEIVED BY: ~ TYPE: CHECK ~: <br /> <br />* THIS IS A VALID PERIVlIT:m THIS PER~IT EXPIRES 180 DAYS FRO~ ITS IS..SUE DATE. IF <br />CONSTRUCTION CF_A~F'~ FOR A PERIOD OF 180 DAYS, OR IF CONSTRUCTION FAILS TO MEET ALL <br />RE(~LIIRE~E~TG OF STATE LANS AND 1~4ARION COUNTY BUILDING AND ZONING ORDINANCES, THIS PERNIT <br />~i~-IALL BECONE NULL AND VOID. <br /> <br />REF1ARKS: TEMP <br /> <br />DONALD E. ~}ODLEY, ~RION COUNTY BUILDING OFFICIAL / BY <br /> <br /> <br />