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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO, 225 <br />220 HiGH STREET NE <br /> SALI=M, OREGON 9'7301 <br /> <br /> PHONE: 588-5147 <br /> 24 HOUR CODE-A-PHONE: <br /> <br />,amperformiflgworkona~ropedylowr~o¢o~cupy, <br />of a registered builder, <br />The work will be pedor~ed by a registered <br /> <br />°WN~TE: 05/05/91 T ~1~.* 9.'03:05 <br />SITUS AOOr~ES¢'I[ LLER,J'IERRY ....... bo~'f~O~fi~N +9P6~ OCCUPANCY: R~D~'r ZAL <br /> <br /> 5555 H~ELL P~IRiE RD SE <br /> AU~V~ L~ OR..9.~325 <br />USE O~ SU~mN~: <br /> <br /> 435 N r~CY ST : <br /> r, ICMiNNVILLE, OR 97128 <br /> PHONE*. 472-7518 SiTE NUfflBER: 11092 <br /> <br />WIr)T~: OE~'fH: ~ j'U~i~S: 8~ : IRREG. LOT; ~ ;CORNER; <br /> <br />TYPE: ELECTRICAL <br /> <br />¢..WrRAc'roR, NO. <br />LICENSE NO: <br />MILLER, JERRY <br />435 N MACY <br />FFCMINNViLLE, OR 97128 <br /> <br />PER~qlT OR APPLICATION NO~ 31990 <br /> <br /> SUPERVISING ELE~TRICiAN/NUr, IBER <br /> <br />SERViCE/FEEDER 101 TO 400 A~II~G <br />ELECTRICAL STATE E~URCHARGE <br /> <br />PAYEE: MILLER, JERRY <br /> <br />:TOTALAL~g~SEO 'FEE~ <br />PRE¥1OUSRECE'IPTS <br /> TH'I~EECEIPT: <br /> <br />QUANTITY Af4OUNI' <br /> 1 $50.00 <br /> $3.00 <br /> <br />$63.00 <br /> $o.oo <br />$63.00 <br /> <br />BALANCE DUE $0.00 <br /> <br />RECEIP'FNO: 33771 <br /> 442? <br /> <br /> RECEIVED BY.* PR .......................... ; .......................... TYPE= CK CHECK ~: <br /> <br />~T~TI~ ~ ~ A ~I~:OF 180 ~. ~ IF ~T~TI~ FAI~ TO N~ ALL <br />~I~ ~ STATE ~ ~D ~i~ ~ BUILDI~: ~D Z~l~ O~IN~, THIS PE~IT <br /> <br /> RE~RKS: SE~ICE ~GE/: 200 ~P ~3588 <br /> <br /> <br />