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MARION COUNTY BUILDING INSPECTION <br />SENATOR~3LDG 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 />BLAIN, LYONALD <br /> <br /> CONTRACT CITY : UGB <br /> 22.5 (~t)Y~fC.Y,~RE OR -- <br /> DEIROi~ OR 97342 <br />USE OF UU~LD~NG DEFROI I NO <br /> <br />RESiDEN ~ JAL <br /> <br />OCCUPANT LOAD <br /> <br />?623 JACK~N HILL RD <br />SALDVl ORE 9?305 <br />PHONE: 585-80'F8 <br /> <br /> VALUA r 1C~: <br />RANGE ZONE <br /> <br />IRREG LOT CORNER <br /> NO NO <br /> <br />MAP <br /> <br />IYPE: ELEC[RICAL PE~MiF OR APPLICATION NO: <br /> <br />33071 <br /> <br />~ONIRAC~OR, NO. <br />LICENSE NO: <br />~LA1N, DONALD <br />7623 ,JACK~ H~LL RD SE <br /> <br />PHON~ 585~8078 <br /> <br />SUPERVISING ELECYRIC[AN/NUMBER <br /> <br />5ERV[Cg/PEEOER 101 <br />ELECfRICAL SI'AI~ ~ROHARf¢b <br /> <br />QU~J~IiJY AMOUNf <br /> 1 $60.00 <br /> $3.00 <br /> <br />FOFAL A~E~EO <br />PR6ViOU$ RECEIPiS <br />FH~S RECEiPF <br /> <br />$63.00 <br /> $0.00 <br />$63_00 <br /> <br />BALANCE 0UE $O_UO <br /> <br /> PAYEE; BLAIN,. 0ONALD RECEiPF NO: 348?4 <br /> RECEIVED BY: OL 1YPE: OK CHECK ~: 65~9 <br /> <br />~< THiE) iS A VALID PERi,lIT ~ THIS PE~IT ~PIR~ 180 ~ F~ ITS i~E ATE. IF <br />~CTI~ C~ FOR A PERIOD OF 180 ~, OR [F ~ST~CTi~ FA[~ TO ~ET ALL <br />~~TS OF STAT~ ~ ~O ~RJ~ ~N~ BUILDING ~O Z~/NG ORD[N~C~, THI~ ~If <br />~ALL BEdE NULL ~ VOlO. <br /> <br />RE,ARKS: SERVICE PANEL CHG 200 AMP R~B536 <br /> <br />DONALD E. NOOOLEY, MARION O~UNIY BUILDING OFFICIAL / BY ......... ~ <br /> <br />~ORM ~ r~ ~S-S~ n~v .~/~o OFFICE COPY <br /> <br /> <br />