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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 have read and agree to the terms ststed on the ro~or5¢ S~de of <br /> <br />SIGNATURE OF APPLICANt <br /> DATE <br /> <br />OWNER <br /> <br /> WELLi~AN, ROBERf <br />SITUS ABDRB~ <br /> <br />TAX lOT CATEGORY <br />CONSIRUCTIQN TYPE OCCUPANCY <br /> <br /> 13294 OAiQUiRI LAKE DR <br />AURORA UR <br /> <br />97002 <br /> <br />NE <br /> <br />CONTRACT CITY UGB <br />MARION COUN'I Y NO <br /> <br />OCCUPANT LOAD <br /> <br />LAKENOOD ~TAlES ~4 <br /> <br /> PHONE: 678-1639 <br /> <br />LOF BLOCK SECTION TOWNSHIP <br /> <br /> 60 100 6000. <br /> <br /> VALUA F i ON: <br /> RANGE ZONE MAP <br /> <br /> IRREG LQT CORNE~ <br />SF NO NO <br /> <br />NO QF BEDfl00M5 <br /> <br />fYPE: ELECfRICAL <br /> <br />CONIRACTOR, NO- <br />LICENSE NO: <br /> <br />PERMII OR APPLiCAflON NO: 32779 <br /> <br /> ~PERVi$iNG ELECIRiCIAN/NUMBER <br /> <br /> If EM <br />BRANCH CIRCUI¥$ ~ ONE <br />EL~(,,~f RiCAL 5¥,~TE SLJRCHA~g <br /> <br />PAYEE: <br />RECEIVbD MY; <br /> <br />f'OIAL A~E'$SED FEES <br />PREVIOUS R~CEIPI'~ <br />fHI~ RECEiPf' <br /> <br />QUANIiTY ~MOUN! <br /> <br />$$5,'f5 <br /> <br /> $o,oo <br /> <br /> NECglPf NO: <br /> PB TYPE: CHSCK ~: 0 <br /> <br />* THIS iS A VALID PE~IT * THiS PER~4IT EXPIRES 180 DAYS FROM /TS ISSUE DATE. iP <br />CONSTRUCTION CF_.ASIES FOR A PERIOD OF 180 DAYS. OR 1F CONSTRUCTION FAILS ~O ~EET ALL <br />~E~UIREI~IENTS OF STATE ~ AND fflARiON COUNTY 8UiLOiNG AND ZONING ORDINANCE.S. THIS PERC4Ir <br />~HALL 8F_f.~E NULL ANDVOiD. <br /> <br />RE~RKS: 1 CiR ~6496 <br /> /'7 <br />i. XONALD E- W©(}DLS!Y, ~ARION COUNIY BUiLDiNG OFFiCiAL / BY ......... //2 <br /> <br />FORM # MC 15-56 REV 4/go OFFICE COPY <br /> <br /> <br />