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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 />SIGNATdHE OF APPLICANT <br /> DATE <br /> <br /> EVERGREEN PARK <br />Elf US ADDRESS <br /> <br />DEN I l AL <br /> <br /> 28O EWERGREEN OR <br /> AUf',~V i LLE <br />USE O¢ BUILOING <br /> <br />OR <br /> <br /> CONTRACT CiTY <br /> <br />~AUD!~Vi LLE <br /> <br />UGB <br /> <br />NO <br /> <br />OCCUPANT LOAD <br /> <br />$UBDWI$1ON <br /> <br />EVERGREEN ESIAIES ~ PARK <br /> <br />Sire NUIV~ER: 13259 <br />VaLUal iON: <br /> <br />MAP <br /> <br />¢¢107 H DEPTll AREA UNITS <br /> <br />IRREG LOT CORNER <br /> NO~ NO <br /> <br />fYPE: ELECfRICAL PERMIT OR APPLiCAFiON NO: <br /> <br />32930 <br /> <br />CONIRACfOR, NO. 27459 <br />LICENSE NO; <br />R ~ R ELECTRIC <br />P.O. BOX 52 <br />IUR~ER, OREGON 9?392 <br />PHONE: ?43-2546 <br /> <br />SUPERViSiNG ELEC1RiCiAN/NU~48ER <br />RU~ELL RiCE / 1673-S <br /> <br /> ITEl4 <br />r4ANUFACfURED HOME SERVICE/FEEDER <br />~LECTRiCAL SiA1E ~JJRt,~ARF.~E <br /> <br />PAYEE: R & R ELECTRIC <br /> <br />FOFALA,SSES.SED FEES <br />PREVIOUS RECEIPTS <br />tHiS RECEiPF <br /> <br />QUANTITY At, IOUNI <br /> $35.00 <br /> <br />$36_75 <br /> $0.00 <br />$36.?5 <br /> <br />BALANCE DUE $0.9~ <br /> <br />RECEIPt NO: 34?24 <br /> <br /> RECEIVED BY: ¢'1 fYPE: CK CHECK ~: 9638 <br /> * THIS iS A VALID PE~IT ~ THIS PERMIT EXP[R~ 180 OAY~ F~4 ITS I,.%~UE DATE. iF <br />~BT~CTI~ C~ ~ A PERIOD OF 180 OA~, OR iF ~T~CTI~ FAI~ TO M~ ALL <br />~IR~T~ OF STATE ~ ~D ~RI~ ~N~ BUILD[~ ~D ~ING ORDIN~C~, THiS ~IT <br /> L B~E ~LL ~D~[O. <br /> <br />REMARKS: MM SVC R~6512 <br /> <br />EXJNALD E. WOODLEY, MARION COUN'I'¥ BUILDING OFFiCiAL / BY <br /> <br />FORM#MC 15.56REV 4/~ OFFICE COPY <br /> <br /> <br />