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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:: 588-8147 8::00 - 4::30 <br />24 HOUR CODE-A-PHONE:: 588-7904 <br /> <br />SIGNATURE OF APPLICANT <br /> DATE <br /> <br /> DAf g: 03/06/91 f 1¢4E: <br />OWNER <br /> <br /> FLOWE~, KYLE ~ OANA <br />511US ADDRESS <br /> <br />TAX LOT CATEGORY <br /> 57 ?0'?/5 ~?0~ <br />CONSTRUCTION TYPE OCCUPANCY <br /> <br /> 225 EvREGRE.P¢,i DR <br />AUM~ViL Lg OR 9?325 <br /> <br /> CONTRACt CITY UGS OCCUPANT LOAD <br /> <br />AUM~VI LL~ NO <br /> NO Or 8EOROOM$ <br /> <br />EVERGREEN bEtAtg5 NIH PARK <br /> <br /> 11373 MILL ~R~EK R~ <br /> AUMSVtLL~, OR <br /> PHONE; Y~9-Y?44 ~Ifg NUMBER: ~2425 <br /> VALUAr1ON~ <br />LOT BLOCK SECTION TOWNSltlP RANGE , ~ONE MAP <br /> <br />55 1 ~/,~ 62?0_ <br /> <br />8S 2~ <br /> IRREG LOT CORNER <br /> <br />SF NO NO <br /> <br />rYP~: ELECtRiCAL P~RNIIf OR APPLICATION NO: <br /> <br />CON i RAG f OR, NO_ 38238 <br />LiCENSE NO; <br />,SAN fiAt4 F1~iLE HOMES <br />I 13t3 ~IlLLOR~EK RD <br />AU~oViL, L,E OR 97~25 <br />PHONE: '/ <br /> <br />SUPERViSiNG ELECYRiCIAN/NUNIBER <br /> <br />MANUFACTURED HOM~ 5~RViCE/F~EOER <br />ELECiRICAL 5YALE SU~HARGE <br /> <br />TOTAL A55E~ED FEE5 <br />PREVIOUS RECEiP'TS <br />'iBIS REOgIPI <br /> <br />BALANCE DUE <br /> <br />QUANiI~Y <br /> <br />AMOUN I <br /> <br /> ~3~ _ ~b <br /> 36. <br /> $o,0o <br /> $o.oo <br /> <br /> PAYEE: RECEIPT NO: <br /> RECBiVE[) BY: GL2 ~YPE: CHECK ~: O <br /> <br />* TH~$ i8 A VALID PER/VlIT * THIS PER/VI~T EXPIRES 188 DAYS FROI14 iTS iSSUE PATE. tF <br />CONSTRUCTION CEASES FOR A PERIOD OF 180 DAYS, OR IF CONSTRUCTION FALLS TO ~EET ALL <br />REQUIREMENTS OF STATE ~ AND ~4ARiON COUNTY BUILDING AND ZONING ORDINANCES. THiS PER~fllF <br />SHALL BECOME NULL AN0 VOID. <br /> <br />GONALD g. WO(i)DLE¥;' MARION COUNTY BUiLDiNG OFFiCiAL / EiY <br /> <br />'ORM # MC 15-56 REV 4/90 OFFICE COPY <br /> <br /> <br />