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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON ~7301'- <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 888-7904 <br /> <br /> of a registered builder. <br /> The work will be performed by a registered builder. <br /> Other , <br /> <br /> DAiE: 0?/03/90 'f',if'4E: 14;29;24 <br />OWNER'. TAX LOT: <br /> · ~'I'OAKES , RiCHAR0 <br /> <br /> 12692 PRY R0 NE <br /> AURORA OR 9?0022 CON'mACT Cra,'; U~: <br /> rAAR J ON COUN'T'Y <br /> <br /> ?HONE: SLTE <br /> VALUAT <br /> <br />LOT <br /> <br />WIDTH: DEPTH: ~RE~,: i g~fTS: IRREG LOT: <br /> NO <br /> <br />NO <br /> <br />CATEGORY: <br /> RE~ i DEN'1' i AL <br /> <br />OCCUPANCY: <br /> <br />TYPE: ELECTRICAL PERMIT OR APPLiCA'f'~ON NO: <br /> <br />25315 <br /> <br />CONTRACTOR, NO. 8281 <br />L~CENSE NO: <br />ENGELMAN 8LEC1RIC <br />P,O- BOX 45~ <br />HUBBARD, OREGON 978~2 <br />PHONE: 98~-804] <br /> <br />SUPgRViSING ~LEC'T'RJCIAN/NUMBER <br />W~. ENGEL,JV~N <br /> <br /> iTEM <br />~ERV CHANGE ONLY-EXi$TING R~SiDENCg <br />ONE NEW BRANCH C~RCUiT;ALI'ER OR EXT6NB <br />FLEE'f' SURO~ARGE ~ZONE 6 <br />~LEC't'RICAL STATE SURCHARGE <br /> <br />QUANTITY AMOUN1 <br /> $30_00 <br /> <br /> $?.~8 <br /> <br />TOTAL <br /> pREVIOUSRECE~PT$ <br /> THiS RECEIP'f' <br /> <br />$0,00 <br /> <br />BALANOE DUE <br /> <br /> PAYEg: E,N6ELMAN ELECIRiC REC~,[P'I- NO: 26808 <br /> REOEiVE0 BY; PR ........................... :,..,;.,.~.:,. .................................................. TYPE: CK OHECK ~: <br /> <br /> THIS ~S A VALID PE~IT THi~ PE~[T ~PI~ 180 ~ F~ ITS i~E ~TE. iF <br />~$T~CTI~ C~ ~R A PERI~ OF 180 ~, OR IF ~T~CTI~ FAi~ TO ~EET ALL <br />~iR~ OF STATE ~ ~D ~Ri~ ~NTY BUiLDIN~ ~O Z~ING OROiN~C~, THIS PE~iT <br />~ALL BEdE NULL ~O ~[P., <br /> <br />OONALO E. ~OODLEY, FCCNRiON C~UN'I'Y BU.£LDING OFFICIAL / BY~~i] .................... <br /> <br /> OFFICE COPY <br />FORM cf MC ~ 5,5~ REV, 4~90 <br /> <br /> <br />