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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 /> DA)E: 01/24/91 II'E: 16:35:27 <br /> <br />OWNFR AUrSVI LLE IV~RKE f <br /> <br />~IGNATURE OF APPLICANT <br /> <br /> DATE <br /> <br />TAX LOT <br /> <br /> 6,30 MAIN <br />A)dfc~V i LL~ <br /> <br />OR 9?325 <br /> <br /> CONSTRUCTION TYPE <br /> <br />AUMSVI LL~L <br /> <br />CATEGOnY Cf.A~IF~ ~ F,'C 1 A L <br /> <br />PHONE~ <br /> <br />SiTE NUMBER*. 12158 <br />VALUA r I ON: <br /> <br />MAp <br /> <br />f YPE *. ELECf RICAL <br /> <br />CON1RACIOR, NO. 61702 <br />LICENS8 NOz <br />I~NSON ELECIRIC <br />2250 JuDECJ1N $'¥ SE <br />SALEM, OR. 97302 <br />PHONE: 364-0??0 <br /> <br />PERMit OR APPLiCA'IiDN NO: 29998 <br /> <br /> SUPERVISING ELECfRICiAN/NUIVlBER <br /> 1873S <br /> <br />SIGN OR OUFLiNg LiGH)ING <br /> <br />PAYEE: ¢4ASON ELECFRIC <br /> <br />1 $36.00 <br /> $1.80 <br /> <br />'rOTAL A~E~ED <br />PREVIOUS RECF 1 Pl'~ <br />FHiS RECSI r~'r <br /> <br />RECEIPf NO: <br /> <br /> $0.00 <br />$37.80 <br /> <br /> $0.00 <br />31703 <br /> <br /> RgCBIVED BY: g,lv12 .... 1YP~: CK CHECK ~: 1579 <br /> <br /> THIS 1~ A VALID PERMIT * THIS P~F~IIT EXPIRE~ 180 DAYS FROM iTS 1~ DATE. <br />~ST~CTI~ ~ ~R A PERIO0 OF 180 DAYS, OR IF ~SI~C~I~ FAi~ TO ~EET ALL <br />RE~i~T~ OF STATE ~ ~D ~Ri~ ~NTY BUILDIN~ ~D Z~ING ORDIN~C~. THIS PE~IT <br />~ALL B~E NULL <br /> <br />RgMARKS: OREGON LOTIERY $1f31N khl~5?B8 <br /> <br />DONALD E. tWOODLEY. MARION COUNTY BUILDING OFFICIAL / BY <br /> <br />FORM ~ MC 15-5~ REV 4/90 OFFICE COPY <br /> <br /> <br />