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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 />I am ~ registered broider OR ~ I the authonzed rep~esentsh,,e SIGNATURE OF APPLICANT <br />of 8 refhstored builder, <br />The work will be performed b'~ a registered builder <br />Other <br />I have read and a,RfOO t(~ tho terms stated on the reverse $1d~2 of DATE <br />thl~, document <br /> <br />ow~,& I'E: 02/05/91 <br /> <br /> LA¥1'4AN, ~(,;~ <br /> <br />TAX LOT CAfEGOR¥ <br />CONSTRgOTION TYPE OCCUPANC¢ <br /> <br />RES! DF..N fiAL, <br /> <br /> 155 DE[R011 AV~ <br /> <br />U~E OF BLHLDING <br /> <br />OR <br /> <br />CONTRACT CiTY U(~B OCCUPANT LOAD <br /> <br />BLOCK 5EGIION TOWNSHIP <br />f}E PTH AREA UNITS <br /> <br />SIIE NUIVlB~- R: 12219 <br />V,ALUA T I ON: <br /> <br />IRPEG LOT CORNER <br /> NO NO <br /> <br />MAP <br /> <br />lYPE: ELECfRICAL PERI, if OR APPLiCAIiON NO: <br /> <br />301 '73 <br /> <br />CONIRACTOR, NO. 44248 <br />LICENSE NO: <br />C(JN`SUMER PONER 1NC. <br />P.O.80X 1~80 <br />PHiLO~Aikl, OR 9?370 <br />PHONEt 929~3124 <br /> <br />~UPERVlSiNG BL6CIRiCIAN/NUMBER <br />3050-`S <br /> <br />SERViC~/PEEOER 101 r'O 400 <br />~LECTRiCAL SYAiE SURCHARGE <br /> <br />QUANIITY AJ"4OUN~ <br /> 1 <br /> <br />FOFAL A,.~E~ED PEES <br />PREVIOUS RECEiPf'5 <br />[HIS RECEIPT <br /> <br />$0_oo <br /> <br />BALANCE OOE $0.00 <br /> <br /> PAYEg: CONSUMER POWBR INC. RECEiPt NO: 31887 <br /> RbCEiVEO ~Y: 0~2 IYPE: CA CH~CK ~: 0 <br /> THiS IS A VALID PER,lIT * THiS PERi, IT EXPIRE8 180 ~ F~ IlS I~E <br />~T~CTi~ C~ FOR A P~RiOD OF 180 DA~, OR iF ~T~CTi~ FAi~ TO REET ALL <br />REdiReCTS OF S1ATg ~ ~D ~RI~ ~NTY BUILDING ~o Z~IN60RDIN~C~, rHZ~ Pg~IT <br />~ALL BE~ NULL ~D VOID. <br /> <br />REF4ARKS: 5gRV' CHGE R~5834 (,HOUSE ACR~ FROCq PO~T OFPIC% <br />DONALD b,,. AIOOOLEY, NAR,tON COUNTY BUILDING O~PfC],AL / BY...~N~X <br /> <br />pon~ ~¢ uc ~ ~-'~ Rev 4/~ OFFICE COPY <br /> <br /> <br />