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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 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE:. 588-7904 <br /> <br />am performing work on a property I own or occupy, <br />lamaregistered builder OR( ) the authorized representative <br />of a registered builder. <br />The work will be performed by a registered builder. <br />Other. <br /> <br />I have read and afjree to the terms stated on the reverse side of <br />this document. <br /> <br />OWNER: DATE: 08/05/90 TIME: <br /> <br /> L El'Cfr!CNg, (,,~,3 RDON <br /> <br />11;41=18 <br /> <br />TAX LOT: <br /> <br />CONSTRUCTION TYPE: <br /> <br /> 12.96(5 RAPLE LEAF C'f' NE : ~ONTR~CT CITY: UGB: <br /> AURORA OR 97002 <br /> RARiON TY <br />gSE OF BUlLDINS~ <br /> <br />40888-000 <br /> <br />CATEGORY~ <br /> <br />OCCUPANCY. <br /> <br />OCCUPANT LOAD: <br /> <br />RES i DEN'f I <br /> <br /> PHONE: ,SI I'E NUFIBER: 10358 <br /> VALUA'F I ON: <br />]LOT: BLOCK: : SEC~iONI fo~/NSHIP: RANGE: ZONE: MAP: <br /> <br /> 22: " EFU 5 <br /> WIDTH: DEPTH: , AREA: UNI¥SI ~'`SIRREG, LOT; I~/~IcoRNER: <br /> ~ AC NO NO <br /> <br />TYPE: ELECTRICAL <br /> <br />CONTRACTOR, NO+ <br />LICENSE NO: <br />LIS'~3N,S, 60ROON <br /> <br />PEI~4IT OR APPLICATION NO+. 24612 <br /> <br /> SUPERVi,SiNG ELECTRiCiAN/NUMBER <br /> <br />TWO OR MORE Nc'*H cIRCUIT,S;AL'F OR EX'F <br />FLEET SJURCHARGE -ZONE 6 <br />ELECTRICAL ETA'rE ;SURCHARGE <br /> <br />TOTAL AE~EE~ED FEES <br />PREA/1CUS RECEIPTS <br />THIS RECEIPT <br /> <br />r4'UAN'I'iTY AIV~UN'F <br /> $30.00 <br /> <br />$39_18 <br /> $o.oo <br />$39.18 <br /> <br /> BALANCE OUE $0.00 <br />PAYEE: LENMONS, 6OR[.3¢,~: RECEIPT NO: 26060 <br /> <br /> RECEIVED BY: c"l ..... ¢2d&d__L_ ........................ TYPE: CK CHECK ~ O <br /> <br /> * THIS IS A VALID PEf~ii~*~HI~ PER~iT EXPIRES 180 DAY~ PRO~I ITS I~E~UE DATE. IF <br />CO~STRUCTiCe~ CEA.~E~ ~.A.~iOD ~ 180 ~, ~ IF ~T~I~ FAI~ TO ~ ALL <br />~iR~ OF STATE ~D ~I~ ~TY~UILOi~ ~D Z~ING ORDINal. THI~ PE~I~ <br /> ALL B~E NULL ~O ~l~. <br /> <br />RE~ARKS: 2 ClR- JACUUZI <br />[)ONALD E. NOODLEY, NARiON C~UNTY BUILDING OFFICIAL / BY ........................ ~ ................................................................... <br /> <br />OFFICE COPY <br /> <br /> <br />