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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />2'20 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-8147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> OA'I'E: 10/28/91 'TL[f~: 75:48:23 <br />OWNER; TAX LOT: <br /> <br /> EVER(:qREEN <br /> <br /> 9~0 YEN ~'f <br />.&t. HvlSV Z LLE <br /> <br /> -- co NT~AC~ C~TY: UgBi <br />OR 97325 <br /> .AUHS¥i LLE : NO <br /> <br />SUBDiVISIOh <br /> <br />CATEGORY; <br /> RE~5i OEN'T I~L <br />OCCUPANOY: <br /> <br />'O~CUPANT LOAD: <br /> <br />NO OF 8EOROOMS <br /> <br />PHONE: <br /> <br />LOT; BLOCK: SECTION: <br /> <br />TOWNSHIP' <br />UNITS <br /> <br /> SITE NUMBbR: <br /> VALUA f iON: <br />RANGE <br /> <br /> RREG I.O3 <br /> NO <br /> <br />CORNER <br /> <br />MAP <br /> <br />'fYPE: ELECTRICAL PEP-~i'F OR APPLICATION NO: <br /> <br />36411 <br /> <br />CONTRACTOR, NO. 27459 <br />LICENSE NO: <br /> R & R E"lec~rffc thc <br />Po 8ox 52 <br />'T'urnen, 9?392-0000 <br />PHONE: 743-2546 <br /> <br />SUPERViSiNG ELECTRICiAN/NUMBER <br /> <br /> i'T'E~ <br />AOOi'f'iONAL P'EE~ <br />EL. EC'fRiOAL STATE SURCHARGE <br /> <br />QUANt'iIY AMOUNf <br /> $30.00 <br /> <br />PAYEE: <br /> <br />R & R E"le¢~Pffc lnc <br /> <br />TOTAL ~E~ED FEES <br />PREVIOUS RECEIPTS <br />THiS RECE.[P'f' <br /> <br />$31.50 <br /> <br />BALANCE DUE $0_ 0(3 <br /> <br />REC~iP'r NO: 38342 <br /> <br /> RECEIVE[} BY: CL TYPE: OK CHECK ~: 9990 <br /> <br />* THIS iS A VALi$ PEF;~4IT ~ THIS PERfVliT ED(PIRIES 180 gAYS FIRO~ iT3 I~E DATE. iF <br />CONSTRUCTION CEASES POR A PERIOD OF 180 DAYS, OR IF CONSTRUCTION FAIL.'5 TO ~EET ALL <br />~E~iRIBvlENT$ OF ~TATE LA.M~ AN~ I~IARIGN COUNTY ~UILDING AND ZONING ORDINANCES, THIS PERt~IT <br />~I'-IALL ~ECO~IE NULL ANDVOI~. <br /> <br />REI~ARKS: MP'G SVC k~3030 <br /> <br />[DONALD E. ~OODLEY, MARION COUNTY BUILDIN~ OFFiCiAL / BY <br /> <br /> OFFICE COPY <br />FORM # MB 115.{~i~ REV, 4/90 <br /> <br /> <br />