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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 $:00 - 4:30 <br /> 24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />Il am performing work on ~ property I own or occupy, <br />~m a registered buitder OR ( ) the authorized repre~entetive SIGNATURE OF APPLICANT'. <br />of a registered builder, <br />The work will be pedormed by a registered builder, <br />Other <br /> <br />this document. <br /> <br /> ! RES ,t CNN T i ,5, L <br /> ALBEE JEFF & ROXANE , <br /> i CONSTRUCTION TYPE: ! 0CCUPANCYi <br /> <br />AU~ViLLE 9? 325 I ~ , <br /> <br /> .................................. ~ALUA:[ [~ ............. <br /> f BL0~K: ~SEOTION'. ~TOWNSHIP; ~ RANGE; [ ZONa~ ~: <br /> <br />LOT: <br />!w~aT~: 3 ~>'~+~: '-'4 i'~/~: .......... ~'$'""'?¥~1'7~: 85""I'i~h~.i-6~:"-"'~1~ "t~6~'~i' 'AS <br /> ~ [ NO NO <br /> <br />TYPE: ELEC'f'R[CAL <br /> <br />CONTRACTOR, NO. <br />LICENSE NO.+ <br />AIREIB, JEFF & f'~OXANE <br /> <br />PHONE: 769-4339 <br /> <br />PEP-~['f OR APPL[CAT/ON NO~ 40632 <br /> <br /> .SUPERVJS[NG ELEC'f'RiCIAN/NU~ER <br /> <br /> i're.~l <br />5Ef-~/ICE/FEEOER L~ 'I'H.~'4 200 ANP~ <br />BRANCH CiRCUiT, WiTH SERVICE OR EEEOER <br />ELEC'f'R[CAL STA'rE ,?SURCHAik~GE <br /> <br />PAYEE: ALBEE, JEFF & ROXANE <br />RECEIVED BY= Dlvl2 <br /> <br />QUAN'ftTY Af4OUN'f' <br /> <br /> 5 $~0.00 <br /> $3.00 <br /> <br />TOTAL A,$S~ED FEE% <br />PREYJOU$ RECE[PT5 <br />THiS ~ECEZP'f' <br /> <br /> $o.0o <br />$63.00 <br /> <br />BALANCE CLIE $0+00 <br /> <br />RECEiP'I NO: 42665 <br />'FYPE: OK CHECK ~: 4488 <br /> <br />~ THIS I~A VALID PER~I13 = THIS PER~IiTEXPIRE~ lBO DAYS FR~Ifl 1TS 1SE~JE DATE. 1F <br />OON~TRUCTION CEASi~5 FOR A PER[OD OF 380 DAYS, OR [F C~NSTRUCTION FAILS TO ~ET ALL <br />REQU[REt4ENTS OF STATE LANS AND r, IARZONC~JNTY BUILDING AND ZON[N~ ORDINANCES, TH[5 PER,liT <br />SHALL BEC~flE NULL ANO VOID. <br /> <br />REfVlARK~: 100AHP/5 CIR <br /> <br />DONALD E. ~-3ODLEY, ~ARJON COUNTY BUiLDiNG OF'FiC[AL / BY <br /> <br />FORU ~ ~c ~-s~ R~V. ,¢0 OFFICE COPY <br /> <br /> <br />