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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM1 OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br /> <br /> am performin9 work on ~i properly I own or occupy. <br />I am a registered builder OR the au horized rep esen a ,ce S GNATURE OF APPL CANT <br />Of a registered builder, <br /> <br />this document <br /> <br />ow~i¥ E: 0?/23/90 <br /> <br /> RAYNE, ViRGiL <br />SITUS ADDRESS: <br /> <br />Y223 SHAW H;NY SE CONTRADTGITY UGB <br />RUN,Vi LLE OR 9?325 <br />USE OF BUILDING. MARiCN COUN FY NC) <br /> <br />OCCUPAN <br /> <br /> SAM( <br /> PHONE: ';~ 4- 9 - 2 '/' f2 '~' <br />: LOT: BLOCK: <br /> <br />SECTION TOWNSN IP: <br /> <br />~i'T'E NUMBER: 'lUZlJ <br />VALUAfI©N: <br />RANGE: EONE <br /> <br />MAP: <br /> <br /> UNITS RRBG LOT CORNER <br />5. AC N(:) NE <br /> <br />5~ <br /> <br />TYRE: BLECiRiCAL <br /> <br />CONTRAC'FOR, NO. <br />L,~CENSE NO: <br />RAYNE, ViRGiL <br />SAME <br /> <br />PHrjNE: 'F49-2707 <br /> <br />PER, If' OR APPL~CAf'ION NO: 2583? <br /> <br /> SUPERViSiNG ELEC'f'RiCIAN/NU~BER <br /> <br /> IFEM <br />5ERV C~ANGE ONLY~EXiS'f'iNG RESIDENCE <br />FL£ET SURCHARGE -ZONE 3 <br />ELEC'FR~CAL STATE .~¢,JRCHARGE <br /> <br />PAYEE: RAYNE, VIRGIL <br /> <br />TOI'AL~J,,~ED FEES <br />PREWIOUSRECE~PTS <br />THiS RECEIPT <br /> <br />QUANTITY AMOUNT <br /> ~ $30.00 <br /> $3.84 <br /> $~-50 <br /> <br />$35.34 <br /> $0.00 <br />$35_34 <br /> <br />BALANCE DUE $0, C0 <br /> <br /> RECEiP'T NO: 2?366 <br /> RECEIVEO BY: CL TYPE: CK C,'HECK ~ ~20 <br /> <br />~ THIS IS A VALI0 P61~iIT * THI~PEI~lZT EXPIRES 180 0AY~ FROM iTS I,%~UE DATE. IF <br />CONSTRUCTZ0N CF_A~E~ FOR A P~RiODOF 180DAY~. OR IF CONSTRUCTION FAiL~ TO MEET ALL <br />~C~JiRE~IENT$ OF STATE LANS AND MARION COUNTY BUILDING AN0 ZONING ORDINANCES, THIS PERMIT <br />SHALL BECOME NULL AND VO10. <br /> <br />REMARKS: ~EVICE CHG ONLY R~3880 <br /> <br />[~NAL~ E. IAtOODLEY, R~RiON COUN'T'Y BUiLDiNG OFFICIAL / BY <br /> <br /> OFFICE COPY <br />FORM # MC 15.56 R~/, 4/90 <br /> <br /> <br />