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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO, 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> ~HONE 588-5147 <br />CODE-A-PHONE 4:30 EM. - 8:00 A.M. <br /> <br /> I sm a registere¢ builder OR ( ) the authorized representative <br /> Other <br /> <br />DATE; 08/17/89 TIME: 9: 16: 0Se,, <br /> DORAN, TOM <br /> <br />SIGNATURE OF APPLICANT; <br /> <br /> DATE[ <br /> <br />TAX LOT: <br /> <br />CONSTRUCTION TYPE: <br /> <br />CATEGORY: <br /> <br />OCCUPANCY: <br /> <br />RESI DENT 1AL- <br /> <br /> 845 8'T'H ST <br />AUMSVI LLE OR 97325 <br /> <br />USE OF BUILDING: <br /> <br />CONTRACT CtT~: UGS: OCCUPANT LOAD: <br />AUMSVI LLE NO <br /> <br />MAILING ADDRESS: <br /> <br />PO BOX 185 <br />SUBLIMITY OR 97385 <br />PHONE: 769-7354 <br /> <br /> SITE NUMBER; 8146 <br /> VALUATION; <br /> ~WNSHIP: RANGE: ZONE: MAP: <br /> <br />25 82 2N RS 51 <br /> UNITS: IRREG. ~T: CORNER: <br /> NO NO <br /> <br />TYPE: ELECTRICAL <br /> <br />CONTRACTOR, NO. <br />LICENSE NO: <br />DORAN, TOM <br />PO BOX 185 <br />SUBLIMITY OR 97385 <br />PHONE: ?69-?364 <br /> <br />PERMIT OR APPLICATION NOt 18211 <br /> <br /> SUPERVISING ELECTRICIAN/NUMBER <br /> <br /> ITEM <br />TEMP CONSTR SERVICE <br />FLEET SURCHARGE -ZONE 3 <br />EEECTRiCAL STATE SURCHARGE <br /> <br />PAYEE: [~)RAN, TOM <br /> <br />TOTAL ASSESSED,FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />QUANTITY ,AMOUNT <br /> 1 <br /> 3,84 <br /> 1,50 <br /> <br />$:35-3& <br /> $0.00 <br />$35,34 <br /> <br />BALANCE DUE $0-00 <br /> <br /> RECEIPT NO; 19821 <br />RECEIVfE, DEtY; P8 TYPE_- IN CHECK ~t; 0 <br /> <br />* ~IS IS A VALID PE~IT:;~ ,%~IS~,PE~IT ~PI~'180 ,DA~,~,ITS t~E ~TE. IF <br />~ST~CTI~ C~ ~R ~ R~I~D",OF,"180 ~,,'~ 'I,E',~ST~CTI~ FAI~ TO ME~ ALL <br />REdIReCTS OF STATE ~ ,~,,~RI~ ~N~,BUI~ING,~D Z~NG ORBIN~C~, ~IS PE~IT <br />~ALL BEdE NULL ~D VO!'D.'?,:~(~;~;',, ,' ,; ' ,:~, ; , ' <br /> <br />REMARKS: ~EMP ...... ' ' .... ' <br /> <br />OONALO E, ~OOLEY, MARION COUNTY BUILDING OFFICIAL / BY _~ <br /> <br />FORM # MC ,5,S6 J~EV 11/8~ OFFICE COPY <br /> <br /> <br />