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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 am performing work on a property I own or occupy <br /> <br />SIGNATURE OF APPLICANT <br /> DATE <br /> <br />~Owd¢AIE; 09/05/91 lIME: 13:24:53 <br /> <br /> gYERGRE~N ~ PARK <br />: BITIJ~ ADDRESS <br /> <br />i TAX LOT <br /> CONSTRUCTION TYPE <br /> <br /> 145 SPRUCE Cf <br />AUM~V I LLE OR <br /> <br />i ~ONTRACT CITY <br />'At~¥t bbE <br /> <br />r UGB <br /> <br />i SUBDiviSiON <br /> <br />NO <br /> <br />CATEGORY <br /> <br />occb~k~bY <br /> <br />0C~0F~N¥ LOAD <br /> <br />.... [NO O,~L~F~OO~S ) <br /> <br /> PHONE: <br /> <br />LOt <br /> <br />SIIE NU~ER: <br /> VALUA F i CNW: <br /> <br /> 14017 <br /> <br />ZONE <br /> <br /> NO <br /> <br />MAP <br /> <br />TYPE: ELECIRiCAL PERMIT OR APPLICATION NO: <br /> <br />34935 <br /> <br />CONIRACIOR, NV, 2T459 <br />LICENSE NOt <br />R & R ~LECIRiC <br />P_O_ BOX 52 <br />IUK~gR, OREGON 9IF392 <br />PHONb: 743~-2546 <br /> <br />SUPERViSiNG ELgOIRiCLAN/NUMBER <br />RU~ELL RICE / 15'73-~ <br /> <br /> iIEM <br />AODIII()NAL FEES <br />ELECIRiCAL SLATE SURCHARGE <br /> <br />QUANIlIY AMOUNI <br /> $30.00 <br /> <br />tOTAL AS,SEnSED FEE5 <br />PREVIOUS RECEIP1S <br />THiS RECEIP~ <br /> <br />$31.50 <br /> $0.00 <br />$3~,5o <br /> <br />BALANCE CUE $0.00 <br /> <br />RECEIPT NO: 36824 <br />TYPE: CK CHECK ~: 9851 <br /> <br />PAYEb: R & R ~LECfRIC <br />RECEIVED BY: cl <br /> <br /> THIS i$ A VALID PEI;~VlIT * THIS PERFIiT EXPIRES 180 DAYS FR0~4 iTS iSSUE DATE. IF <br />~ST~JCTION CF~A.SES ~ A P~RIOD OF 180 DA~. OR IF CQNSTRUCTIDN FAILS TO MEET ALL <br />RE~)UIRE~MENTS OF STATE LAINSANDMARION COUNTY BUILOINGAND ZONING ORDINANCES, THIS P~RMI1 <br />EldALL BE(~0¢46 NULL ANDVOiD. <br /> <br />REMARKS: NH 5VC FOR PARK 5PACE <br /> <br />[.YJNALD g.. WOOOLEY, MARION COUNTY BUILDING OFFICIAL / BY <br /> <br /> <br />