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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 /> of a registered builder, <br /> The work will be performed by a registered builder. <br /> <br />CA'rE: o?/71/90 'riME: 9:'17~48 <br /> <br /> J OHN,~i~N , PA'rRIOIA <br /> <br />SIGNATURE OF APPLICANT: <br /> <br />TAX LOT: <br /> 90050-350 <br />CONSTRUCTION TYPE: <br /> <br />OCCUPANCY: <br /> <br />RFSI DEN r <br /> <br /> 885 8'rH <br />AUIvlSV i LLE OR <br /> <br />USE OF Bt. JlLOiNG: <br /> <br /> CONTRACT CITY: UGB: <br />9?325 <br /> ~I~:~VILLE : NO <br /> <br />MAILING ADDRESS: <br /> <br />PO BOX 722 <br />AUrflSVILLE OR 97325 <br />PHONE: 749-1967 SITE NUFtBER; 10619 <br /> VALUAT iON: <br />kOT: OLOCK: T SECTION: TOWN~H fP: RANGE: ZONE: <br /> <br /> 8 3 25 8S 2W RS <br />wig f H: OEPTH: AREA; UNITS[ IRREG. LOT: CORNER: <br /> 70 95 ' 6650. SF NO NO <br /> <br />FAIR OAKS ES'FAf'E3 <br /> <br />MAP: <br /> <br />TYPE= ELECTRICAL <br /> <br />CON I'RAC'T'OR, NO. <br />LiCP]~SE NO++ <br />JOHN~JJON, PATR1CIA <br />PO BOX 722 <br />AUffCr3VI LLE OR 97325 <br />PHONE: 749-1967 <br /> <br />ONE NE3N BFC~NCH CIRCUIr';AL'rER OR EX'tENS <br />FLEET ~AJRCHARGE -ZONE 3 <br />ELECTRICAL STATE SURCHARGE <br /> <br />PERNI'r OR APPLiCATiON NO: 90254?? <br /> <br /> ,~UPERVI SING ELECI'RICiAN/NUfflSER <br /> <br />r,;,~AN'f I TY A.fvIOUNT <br /> 1 $20.00 <br /> $3.84 <br /> $1 _oo <br /> <br /> TOTAL ASS~ED P'E~ $24.84 <br /> · : PR~//~I.i$ RECEIPTS $0- 00 <br /> , THIS RECEIPT $24.84 <br /> <br /> :BALANCE 0UE $0.00 <br /> <br /> PA?.EE: JOHNSON,. RECEIPT NO: 26987 <br /> ~ECEZVED BY; ~ TYPE= [N ~ECK ~ 0 <br /> <br />· THI~ [~ ~T A ~iT. :: ~IS,~[~TI~ ~ ~ TH~ A ~I~ P~ ~ERE THE <br />~L~[NG ~T ~E ~ED::::' 'THE ~[BILZTY OF THE APPLi~T TO ~ THAT <br />ALL N~ [N~T[~ H~:B~ ~:~+ <br /> <br />PLAN REVIEI4: BY <br /> <br />RE~ARKS: 1 <br /> <br />SA'rE <br /> <br />ci'ry JURISDICTION: BY DATE <br /> <br /> OFFICE COPY <br />FORM ~ MC 15-56 REV. 4/9o <br /> <br /> <br />