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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 />t am performing work on a oroperty I own or occupy. / <br />I am 8 registered builder OR the authorized representative S GNATURE OF APPL (~NT: <br />of e registered builder, <br />The work will be performed by a registered builder, <br /> <br />I have read and agree to the terms stated on the roverge side of DATE: <br />this document, <br /> <br /> UA'rE: 08/31/90 IIME.- 9:35:34 <br />OWNER. <br /> JOHNSON, PA'I'RICIA /GIBSON, rS'I'EVE <br />s TUS AODRESS' <br /> <br />R~iBEN'I'iAL <br /> <br /> 885 6'FH ST <br />AUM~VILLE OR <br /> <br />USE OF BOILDINGI <br /> <br />97325 <br /> <br />CONTRACT CrTY UOS OCCUPANT LOAD <br />rUt, ffSV I LLE NO <br /> <br />MAILING ADDRESS: <br /> <br />PO BOX ?22 <br />AUIv~VILLE OR 9?325 <br />PHONE: 749-1967 <br /> <br />LOT BLOCF SECTION; <br />8 ~ <br /> <br /> 70 95 <br /> <br />SUBDIVISION <br /> <br />FAIR OAKS ES'f'AI'E',S <br /> <br /> SiTE NUMBER: 10619 <br /> VALUA'r t ON: <br /> <br /> 25 8~ 2W RS 51 <br />6650. SF NO NO <br /> <br />TYPE: ELEC'f'R f CAL <br /> <br />CON'~'PC~C'I'OR, NO. 65441 <br />LICENSE NO: <br />RED BALL ELEC <br />1293 R&~KCREEK DR S <br />SALE/~I 97306-0000 <br />RHONE: 581-7893 <br /> <br />PER~['r OR APPLICATiON NO: 26899 <br /> <br /> SUPERVISING ELEC'f'RJCIAN/NUMBER <br /> <br /> 1TE~ <br />.SERV CHANGE ONLY-EXi~'riNG RESIDENCE <br />C/~ SERV TO lO0 AMRS <br />FLEEr SURCHARGE -ZONE 3 <br />ELECTRICAL STATE SURChARgE <br /> <br />(~JAN'I'iI'Y AMOUNI' <br />1 $30.00 <br />1 $45.oo <br /> <br /> 3-~5 <br /> <br />PAYEE: RED BALL ELEC <br />RECEIV£D BYt CL <br /> <br />'ro'rALAE,SIgE,SEU FEE,~ <br />PRE¥10US RECEIPTS <br />'f'HI8 RECEIPT <br /> <br />$82.59 <br /> $o.oo <br />$82.59 <br /> <br />BALANCE DUE $0. O0 <br /> <br /> RECEIPT NO: 28454 <br />........... 2 ...................................... ~ ...................... ................... TYPE= CK CHECK ~: 4719 <br /> * THIS Z8 A VALID PER~qIT * ITS [Ex.SUE DATE. IF <br /> CON~TRUCTIONCEASE~ FOR A PERIOD OF 180DAYS,:ORIF~TRUCTION FAIL..5 TO FIEET ALL <br /> ~E~UI~T$ OF ~TATE ~AND I~ARIONCOUNTYBUiLDING ANDZONING ORDINANCI~. THIS PEI~iT <br /> ~HALL 8ECOI~E NULL AND VOID. <br /> <br />R~f4ARKS: 100 AMP-BARN & S'¢C~RE~" R'¢,4008 <br />BONALU E. ~SIOOLE¥, MARION OOUNTY BUiLOING OFFICIAL / BY .................. ~ ................................................................. <br /> <br />OFFICECOPY <br /> <br /> <br />