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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 />Other <br /> <br />~IGNATURE OF APPLICANT <br /> DATE <br /> <br /> DARE= 06/13/91 lINE: <br />OWNER <br /> <br /> EVERGREEN PARK <br />SITUS ADDRESS <br /> <br />TAX LOT <br /> <br />CONSTHUC liON TYPE <br /> <br />RES ~ DEN T I AL <br /> <br /> 2?0 EVERGREEN DR <br />AUF'&.SV I LLB OR <br /> <br />CONTRACT CITY <br /> <br />UGB <br /> <br />NO <br /> <br />EVERGREEN ESIAIES NtH PARK <br /> <br />sire NUIN1BER: 13258 <br />VALUAIION: <br /> <br />MAR <br /> <br />NO NO <br /> <br />FYPE: ELECTRICAL PER~Ii'F OR APPLICAFION NO: <br /> <br />32929 <br /> <br />CONIRACTOR, NO. 2?459 <br />LICENSE NO; <br />R ~ R ELEC1RiC <br />P.O. BOX 52 <br />~UF~NER, OREGr,3N 9?392 <br />PHONE: 743-2546 <br /> <br />SUPERVISING ELECfRJCIAN/NUMNER <br />RUSSELL RICE / 1673-S <br /> <br />MAN~FAC[URED HOI~E ,SEk~CiC~/FEEDER <br />ELECIRICAL SIAIE ~Rf~ARGE <br /> <br />Ar4OUNf <br /> $35.00 <br /> <br />FOFAL ASSESSED FEES <br />PREVIOUS RECEiPf5 <br /> <br />$36. ?'5 <br /> $0.00 <br /> <br />BALANCE DUE $0.00 <br /> <br /> PAYEE: R & R ELECtRiC RECeIPt NO: 34723 <br /> RECEIVED BY: c] TYPE~ CK CHECK ~: 9638 <br /> <br />~ THIS iS A VALID PEr,lIT * THIS PEi~IlT 8XPIRE~ 180 DAY5 FRC~4 1TS I[~:~JE DATE. IF <br />CONSTRUCTIO~ CE. ASE~ FOR A PERIOD OF 180 OAY~. OR IF CONSTRUCTION FAILS fO ~EET ALL <br />RE~UIREf4ENT$ OF STATE LA%~ AND rAARION COUNTY BUILDING AND ZONING ORDINANCF'q, THIS PER,lIT <br />SHALL BECOK4E NULL ANDVOID. <br /> <br />REMARKS: 1'4H 5VC R~B512 <br />CONALD E. [,gOODLEY~ rVtARION Or.,~JN~Y BUILDING OFF'[C~AL / BY .~ <br /> <br />~ORM ~ MC 15,,58 REV 4?90 OFFICE COPY <br /> <br /> <br />