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MARION COUNTY BUILDING INSPECTION <br />SENATOR,43LDG. NO. 225 <br />2,',',',',',',',',',~0 HIGH STREET NE <br /> SALEM. OFII=GON 97301 <br /> <br />PHONE: 588-5147 8:00- 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 _ <br />[am ¢erforming work on a property l own or oOOuby. ~'~ ' '~ '~ %.~~'~- <br />I am a registered builder OR the authorized representative SIGNAYURE OF APPLIOAN~ <br />of a registered builder. <br />The work wBI be performed by 8 registered builder, <br />Other <br />I have read and agree to the terms stated on the reverse side of DATE: <br />this document <br /> <br />06/28/90 liME: 12:25;47 <br />POR i ER <br /> <br />COf4MERC J, AL.. <br /> <br /> LITTLE RD SE CONTRACT CITY gGB <br />AUC4SV i LLE OR 97;~25 <br /> ~RiON COUN"f'Y NO <br /> <br />OCCUPANT LOAD. <br /> <br /> NO 0¢ RF{)R00M~ <br /> <br /> PHONE: SiTE NUMBER: 10541 <br /> VALUATIOf4: <br />LOT BLOCK' SECTION TOWNSHIP RANGE: ZONE <br /> <br />W DTM: DEPTH' AREA UN~TS: IRREG. LOT CORNER <br /> 0. NO NO <br /> <br />'fYPE; ELEC'f'R~CAL <br /> <br />CONTRACTOR, NO. 2'7459 <br />LICENSE NO: <br />R & R EL£C'FRiC <br />P.O. 8OX 52 <br />TURNER, ORE(~ 97392 <br />PHONEt 743-2546 <br /> <br />PERMIT' OR APPLICA'rlC~ NO: 25229 <br /> <br /> SUPERVISING ELEC'rRiCIAN/NUIV~ER <br /> RUSSELL RICE / 1873-S <br /> <br /> i'fE~ <br />IRRI~C~.'f'ION PUMP <br />C/i SERV 'f'O 100 AMPS <br />FLEET SURCHARGE -ZONE <br />ELECTRICAL STATE SURCHARGE <br /> <br />PAYEE: R ~ R ELECTRIC <br />RECEIVED aY: PR <br /> <br />¢.)UAN'T'i'f'Y A74OUNT' <br /> 1 $45_00 <br /> 3.'15 <br /> <br />TOTAL ~f-'~SSED FEES <br />PREVIOUS RECE J, F'T~ <br />'tH iS REOEi:PT <br /> <br />$82_59 <br /> <br />$82.59 <br /> <br />BAL,~4OE DUE <br /> <br />RECEIPT NO: 26'708 <br />TYPE: CK CHECK ~ 8603 <br /> <br />~ THiS IS A VALID PERi, IT * :THIS PER~IT EXPIRES 180 OAY~ FROM ITS ISSUE DATE. IF <br />CONSTRUCTION CEASES FOR A PER/ODOF180DAY~, ORIF C~N~TRUCTION FAILS TO NEET ALL <br />REQUIRS~/TS OF 5~ATE ~ AND. I~/~J~ION COUNTY BUILDING AND ZONING ORDINANCES. THIS PER~IT <br />~iHALL BECO~IE NULL AND VOID. ~ <br /> <br /> REMARKS: SERV 100 A~P & iRR P~P R'~2564 <br /> <br /> DONALD E. I~ODLEY, IVlARtON COUNTY BUiLDiNG OFP'tCZAL / BY ; ......................... <br /> <br />OFFICECOPY <br /> <br /> <br />