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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 8;00 - 4::30 <br />24 HOUR CODE-A-PHONE:: 588-7904 <br /> <br /> Other. <br /> <br />DARE: 12/18/90 riME.* 9:07:04 <br /> <br />~IGNATURE OF APPLICANT <br /> DATE <br /> <br /> TAX LOT <br /> <br /> QONSTRUCTION TYPE <br /> <br />CAYEGORY <br /> <br />OCCUPANCY <br /> <br />RES1 DEN ~ iA ,, <br /> <br /> 235 EYbRGR~EN DR <br />~LI~V! LLE OR 97925 <br /> <br /> CONTRACT CITY <br />AUIv~VI LLE <br /> <br />NO <br /> <br />OCCUPANT LOAD <br /> <br /> NO 0r 6FnROOM$ <br /> <br />P.O. BOX 157 <br />AUrcf~ViL~E. OR 97925 <br />PHONE: ~49-1527 <br /> <br />LO] 8LOCK SECTION ]'OWNSHIP <br /> 55 115 8325 + <br /> <br />SUBDIVISION <br /> <br /> EVERGRE~ Fr.J~ ! LE ES IAI E <br /> <br /> SI1E NUMBER: 11928 <br /> VALUA T ~ ~: <br /> <br /> RANGF ZONF MAI' <br /> <br /> IRR~G LOT CORNER <br />SF NO NO <br /> <br />TYPE: ELECTRICAL PERMi'r OR APPLICArlON NO: <br /> <br />29279 <br /> <br />CON rP c'roR, NO. 27459 <br />LICENSE NO.· <br />R & R ELECTRIC <br />P.O. BOX 52 <br />1URNER, OREGON 97392 <br />PHONE: 743-2546 <br /> <br />SUPERVISING ELEC1 RiCiAN/t~UMB~R <br />RU3~SELL RiCE / 1679-S <br /> <br /> ITEM <br />~UFAC'FURED HDfVlE SERViCE/FEEDER <br />ELECIRiCAL 51Air'; E:~_JRCHARGE <br /> <br />QUAN li 1Y AI'~OUN T <br /> 1 $35,00 <br /> $1. '15 <br /> <br />TOTAL ASSESSED FEES <br />PRE"V I E~J$ RECEI pIIFS <br />THIS RECEIPT <br /> <br />36.75 <br />36.75 <br />$0+00 <br /> <br />BALANCE DUE $0. O0 <br /> <br /> PAYEE: R~CEIPF NO: <br /> RECEIVED BY: ¢] TYPE: CHECK ~: 0 <br />= THIS I$ A VALID PERt*liT * THIS PER,lIT EXPIRE~ 180 DAY~ FRO~I ITS I~E DATE+ iF' <br />~ST~CTi~ C~ ~R A ~RI~ OF 180 ~. ~ IF ~T~CTI~ FAI~ TO NEET ALL <br />RE. fReTS OF ~TATE ~ ~D ~I~ ~TY 8UILOiNG ~O Z~ING O~IN~. THIS PE~IT <br />~ALL 8~ NULL ~O ~ID. <br /> <br />RP..MARKS: ~tOBILE HCME SERV <br /> <br />GY,)NALD g. NOODLEY, iV~RiON COUNTY BUILDING OPPICiAL / BY ~ <br /> <br /> OFFICE COPY <br />FORM ~ t~O 15-56 REV 4/90 <br /> <br /> <br />