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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:: 588-514'7 8::00 - 4.30 <br />24 HOUR CODE-A-PHONE:: 588-7904 <br /> <br />I 8m performing work on a property I own or occupy <br />lam a registered buddorORf I the authorized representatiYe <br />of a rogistered builder, <br />The work will be performod b~ a Registered budder <br />Otl~or <br /> <br />SIGNATURE OF APPLICANT <br /> <br />OwN~fE: 06/04/91 f~ME: 16:05:54 <br /> <br /> THE EQUi1Y GROUP 1NC <br /> <br /> CONSTRUCTION TYPE <br /> CONTRACT CITY <br /> <br />MARION COUN f'Y <br /> <br />19656 ELK LAKE WAY NE <br />AURORA OR 97002 <br />USE OF SUILDING <br /> <br />1905 NW 169rH PLACE <br />BP...~VERION 97006 <br />PHONE: 629-5000 <br /> <br />LOT BLOCK SECTION TOWNSHIP <br /> <br />$i1E NUf4EIER: <br /> VALUA f i ON: <br />RANGE <br /> <br /> 1 2 <br />WIOTH BERTH AREA UNITS IRREG <br /> <br /> CATFGOPY <br /> OCCUPANCY <br /> OCCURAN"T LOAD <br /> <br />NO <br /> <br />LAKE~OOB ~IAIE$ <br /> <br /> 13154 <br /> <br /> ZONE <br /> <br /> CORNER <br /> <br /> NO NO <br /> <br />RE$1OEN¥iAL <br /> <br />MAP <br /> <br />fYPE: ELBCI'RICAL PERMIT OR APPLICAtiON NO: <br /> <br />32696 <br /> <br />CON IRAC'fOR, NO. <br />LICENSE NO: <br />fHE 6~UI1Y GROUP iNC REALFORS <br />1905 NW t69f'H PLACE <br />B~AVERION 97006 <br />PHONE: 629-5000 <br /> <br />SUPERVISING ELECIRiCIAN/NUf4BER <br /> <br /> iIEM <br />RECCAINEC[ ONLY <br /> <br /> QUAN I I f Y <br /> 1 <br /> <br />1OIAL ASSE~ED F~-~ <br />PREVIOUS RE'CEi P'f'S <br />)''HIS RECEIPT <br /> <br />SAUCE ~E <br /> <br /> AIvK.)UNT <br /> $35_00 <br /> <br /> $35.00 <br /> $35.09 <br /> $0.00 <br /> <br />10868 <br /> <br /> PAYEE: fHE EQtJi')''Y ~ROUP INC RF_.&LTORS RECE~PI NO: <br /> RE~VEU BY: Df42 tYPE: CK CHECK ~: <br /> <br />~ THiS I~ A VALID PE~41T ~ THIS PER~FlIT EX~ii~S 180 ~ F~ iTS I~E ~TE. if <br />~ST~CT[~ C~ ~R A ~IOD OF 180 ~, OR IF ~T~CTI~ FAI~ TO ~E~ ALL <br />~IR~TS OF STATE ~ ~D ~RI~ ~ BUILDING ~O Z~iN~ ORD[N~C~. THI~ ~IT <br />~ALL B~E NULL ~O ~IO. <br /> <br />RF}VlARK,~: R~CONNECf <br /> <br />DONALD E. b~OOULEY, I¥1ARION COUNIY BUiLDiNG OFPiCIAL / 8Y <br /> <br /> OFFICE COPY <br />FORM # MC 1~-56 REV <br /> <br /> <br />