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MARION COUNTY BUILDING INSPECTION <br />SENATORBLDG NO, 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 @;:00 - 4::30 <br />24 HOUR CODE-A-PHONE;: 588-7904 <br /> <br />Other <br /> <br />~IGNATURE OF APPLICANT <br /> DATE <br /> <br />ow~l~; 03/05/91 TIME= 8:27;34 <br /> PLOWiNg, KYLE & DANA <br /> <br />SITUS ADDRESS <br /> <br /> TAX LOT <br /> <br />: CONSTRUCTION TYPE <br /> <br />CATEGORY <br /> <br />RES i DEN 1 ! AL <br /> <br /> 225 EVREGR~'EN OR <br />AUIviSVi LLE OR 97326 <br /> <br />USE OF BUILDING <br /> <br /> CONTRACT CIIY <br /> <br />AUC45V ~, LLE <br /> <br />UGB <br /> <br />NO <br /> <br />OCCUPANT I.OAD <br /> <br />MAILING ADDRESS <br /> <br />11373 f~iLL CREEK RD <br />AUNTY i LLE, OR <br />PHONE: 'F~59-7744 <br /> <br />LOT BLOCK SFCTION TOWNSHIP <br /> 25 8S <br /> 55 114 6270. SF <br /> <br />PARK <br /> <br />SIIE NU~ER: 12425 <br />VALUA f I C'¢4: <br />RANGE ZONE <br /> <br />IRREG LOT CORNER <br /> NO NO <br /> <br />IYPg: ELbCIRiCAL PER~III OR APPLICA'TION NO: 90307'31 <br /> <br />CON fRACfOR, NO. 38238 <br />LiCgN~E NO; <br />SAN f'iAR F'K)BiL£ HO~ES <br />'11373 ~ILLCREEK RD 5E <br />AUNI~VlLLE OR 97325 <br />PHONE: <br /> <br />SUPERViSiNG ELECFRICiAN/NUMBER <br /> <br /> If'EM <br />IAANUFACfUREB HO~b 8WRVlCE/FEEOS~ <br />ELECIRiCAL 5fA~E ~AJRCHARGE <br /> <br />PAYEb: 5ANTiA~4 [~3BiLE HOfflES <br />~tEC6IVED BY: PR <br /> <br />O~JANIlIY <br /> 1 <br /> <br />FOfAL ~ED P'E6S <br />PREVIOUS RECEiPIS <br />'f'H[8 RECE~Pf <br /> <br />BALANCE DUE <br /> <br /> RECEiPF NO: <br />fYPE: iN CHECK <br /> <br /> A~L)tJN l <br /> $35,00 <br /> <br /> $o.0o <br /> $36,?5 <br /> <br /> $o.oo <br /> <br />3245'? <br /> <br />* THIS iS NOT A PERI41T. THiS APPLICATION i~U~T GO THROUGH A REViE~ PROCE~,S H,~-IERE lHE <br />FOLLONiNG I~.JST BE COIqPLETED. iT IS THE RE~I:~NSiBiLiTY OF THE APPLICANT TO ~RE THAT <br />ALL NECE:~:~RY INPOR~IATION HA~REEN PI~3VlDED. <br /> <br />PLAN REVIEW: BY <br /> <br />RE,'"4ARKS: ~H f~ERV <br /> <br />OAl E <br /> <br />CIIY JURiSDiCTiON: BY DATE <br /> <br />~oRm ~ mc ,~-~ R~.v 4/~o OFFICE COPY <br /> <br /> <br />