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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 />of a registered builder, <br /> <br />I ha~e read and agree to the terms stated on the reverse side of <br /> <br /> EVERGREEN <br /> <br /> DATE <br /> <br />TAX LOT <br /> <br />CATEGORY <br /> RESi DEN f IAL <br /> <br />OCCUPANCY <br /> <br /> 210 EVEF~RE~ OR -- <br /> co N'f F~ACT CITY UGB <br />ALJN~Vt LLE OR 9?325 <br /> AUIv~VILLE <br /> <br />USE OF BUILDINC~ <br /> <br />NO <br /> <br />OCCUPANT LOAD <br /> NO OP <br /> <br />EVERGREEN MH ESIAI E5 <br /> <br /> PHONE: Sl IE NUIVBER: 13087 <br /> VALUA f ION: <br /> <br />LOT RI OCK SECTION TOWNSHIP RANGE ZONE <br /> NO NO <br /> <br />MAp <br /> <br /> fYPE: ELECTRICAL PERMit OR APPLiCATiON NO: 32450 <br /> <br />CONIRAg;fOR, NO, 2?459 5UPgRVlSiNG gL~CfR~CIAN/NUMf~gR <br />LICe, NSF NO: ~LL RiCh <br />R ~ R ELECiRIC <br />P,O,, BOX 52 <br />TURNER, ORE~N 9t392 <br />PHON~: 'f43~25~6 <br /> <br />MANUPACIURb, L) HOME SERViCE/FEEDER <br />L.L_EC/RICAL 5¥AiE SURCHARGE <br /> <br />PAYEE: R & R ELgC'fRIC <br />RbCblVb, D BY: CL <br /> <br />QUAN [ ~ fY AMOUN / <br /> $35-00 <br /> $ ]. '~ 5 <br /> <br />TOFAL AE43E~ED FEES <br />PREVIC,,~.J5 RECEIPT5 <br /> <br />$3~.75 <br /> $o,,o0 <br />$36,?5 <br /> <br />BALANCE DUE SO-OB <br /> <br />RECEIP'f NO: 3423"¢ <br />1YPE: CK CHECK ~: 9584 <br /> <br />* 7HIS iS A VALID PERI~IT * THIS PER~4IT EXPIRBS 180 [:~AYS FRO¢4 1TS iS.gJ~ DAT~. IF <br />CONSTI~J~TiON CEASES FOR A PERIOD O~ ]80 DAY~, OR IF 6ONS'TI~IJCTiON PAILS TO M~ET ALL <br />REQUI~E~4TS OF STATE ~ AND PtARiON COUNTY BUILDING AND ZONING ORDINANCES. THiS <br />SHALL BECOC4E NULL AND VOID. <br /> <br />REMARKS: MH 5VC R~6440 <br /> <br />DONALD E. NOODLEY, ~ARiON COUNYY BUILDING OFFICIAL / BY <br /> <br /> OFFICE COPY <br />FORM # M~ 15-56 RE¥ 4/90 <br /> <br /> <br />