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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 performin9 work on a property I own or occupy. <br /> I am a registered builder OR ( ) the authorized representative SIGNATURE OF APPLICANT; <br /> Ct a re(]istered ,builder. <br /> The work will be performed by a registered builder. <br /> Othor-- <br /> I have ead and agree to the terms sta~ed on the reverse side of DATE: <br /> <br />OArE: ~0/29/9 ] TIME: 8:08:44 <br /> GREEN, JOE '/'0551L491 <br /> <br />OATEGORY: <br /> <br />OCCUPANCY: <br /> <br />RES i DEN f 1 AL <br /> <br /> ] 1556 FALCON CT -- CONTRACF CITY: ' UGS: !OCCUPANT LOAD: <br />AURORA OR 9?'002 <br /> <br />20 WALKING NO'OD OR <br />LAKE GS~EGO~ OR 970~5 <br />PHONE: 636-791 ~ <br /> <br /> SI'~E NUMBER: <br /> VALUATION: <br /> BI,,OGK: SECPON: TOWNSHIP: RANGE: <br /> <br />60 85, 5100. BP' NO <br /> <br />CENTRURY fflEAOOWS <br /> <br /> 14642 <br /> <br /> ZONE: <br /> <br /> CORNER: <br /> NO <br /> <br />MAP: <br /> <br />/YPE; ~LEC'f'RICAb <br /> <br />CON'I'R.~CTOR, NO. 35~$1 <br />LICENSE NO: <br /> PARKtN ELECTRIC iNC <br />252~8 S~ O'~E~3'~' RD <br />~ERW~JOD, 97140 <br />~ONE: 7?8-0374 <br /> <br />PERMIT OR APPLICATION NO: 362'73 <br /> <br /> ~PERViSING ELECTRICIAN/NUHBER <br /> <br /> i f' EM <br />I~IANt FAC'fUR,~D HOME S~RViCE/FEEDE'R <br />E. LI~:C[RiCAL r~A¥'E SURCHARGE <br /> <br />QUAN ]'i tY AIVIQUN 7' <br /> ~ $35. O0 <br /> $1. <br /> <br /> 'I'O'f'AL A~E~ED FEES $36.~5 <br /> PREVIOUS RECEIPTS $36_75 <br /> THi~ RECEipT $O.OO <br /> <br /> BALANCE DUE $8.00 <br /> <br /> PAYEE: RECE1P'¥ NO: <br /> RECEIVED BY: Of 42 .................................................................................................................... 'I'YP~; CHECK ~; 0 <br /> <br />~ THIS IS A VALID PEFCtlT ~ THIS PERi, IT EXPIRE~, 180 DAY~ FROf~ IlS i~E BATE. 1F <br />~T~Ti~ C~ FOR A P~RiOD OF 180 ~Y~. OR IF ~T~CTI~ FAI~ l'O M~T ALL <br />~I~T~ OF ~TAT6 ~ ~O ~RI~ ~NTY BUiLOING ~D Z~ING ORDIN~C~, THIS P~iT <br />~ALL ~6 NULL ~O ~IO. <br /> <br />I~EMARKB: MH SVC ONLY R~38~5 <br /> <br />DONALD E. NQODLEY, MARION COUNTY BUiLDiNG OFFiCiAL <br /> <br />OFFICE COPY <br /> <br /> <br />