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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.)A':E: ]2/30/91 liME: ]/4:27:03 <br /> PERR ! S <br /> <br />SIGNATURE OF APPLICANT: <br /> DATE: <br /> <br /> ~AX LOT: <br /> <br /> CONSTRUCTION TYPE~ <br /> <br /> CA FEGORY: <br /> <br />: OCCUPANCY: <br /> <br /> 80?4. MIL_I_ (.;REEK RD <br />,AUMGV l LLE OR <br /> <br />97325 <br /> MARION CGUN'f'Y <br /> <br />NO <br /> <br />OCCUPANT LOAD: <br /> <br /> PHONI:: SIi'E NUMBER; ]5298 <br /> VALUAT iON: <br />LOf 8LOGKr ~CTIOI~; TOwNSRIP; RAN(~E: : z~NE: <br /> <br />WIGAN DEPTH: AREA; u Ni~S: iRREG, gO~: :CORNER: <br /> NO : NO <br /> <br />RES 10EN :' 1 AL <br /> <br />MAP: <br /> <br />I YPL: ELECTRICAL PE~I'[' OR APPLICA'f'fON NO: <br /> <br />3?699 <br /> <br />CON ]'RACTOR, NO. <br />LICENSE NO: <br /> Judsens inc <br />PO 8ox 12669 <br />Sa leto, 9'1309-0000 <br />PHONE: 363-414] <br /> <br />SUPERVISING ELEC'¥'R 1C 1AN/NU~t~ ER <br /> <br /> t ]' EM <br />B:;ZAN~ CIR~CUi'f'5 - TWO TO TEN <br /> ECIRiCA.~ 5'TATE SURCHARGE <br /> <br />PAYEE; Judson~ inc <br /> <br />'f'O'fAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS R~%EiP'f' <br /> <br />QUAN'T'['T'Y AMOUNT' <br /> $2,50 <br /> <br />$52,50 <br /> $0_ O0 <br /> <br />BALANCE DUE $0,00 <br /> <br />RECEIPT NO: 39675 <br /> <br /> RECEIVED BY: CL TYPE; CK CHECK ~= '16!'L9 <br />~ THIS IS A VALID P~R~41T * THIS P~R~IiT E XPIRE~ 180 DAY~ FRO~ J'~'S ISSUE DATE. IF <br />CONSTRUCTION CEAS~ POR A PERiOQOF 180 DAYS, OR IF CONSTR~OTiON PALLS TO R£~T ALL <br />REQUiRE~IENTS O~ STAT~ LA~5 AND ~tARION COJNTY BUILOING AND ZONING ORDINANCES, TH~5 PgF~iT <br />SHALL B~CO~E NULL AND VOID. <br /> <br />REN1A. RKS: FOR HEATING CiR & U~STAiRS RECEPfABLE -OWNER ALSO DOING WORK <br /> <br />DONALD E, WOOOLEY, MARION COUNTY BUILDING OP'FICIAL / 8Y ................................................. <br /> <br />OFFICE COPY <br /> <br /> <br />