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MARION COUNTY BUILDING INSPECTION <br />SENATOR BI,.DG, 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 />of a registered builder, <br /> <br /> this document. <br /> <br /> LEWIS F'A~ <br />A~DRESS' ' <br /> <br />SIGNATURE OF APPLICANT <br /> <br /> DATE: <br /> <br /> TAX LOT <br /> <br /> CONSTRUCTION TYPE. <br /> <br /> 11842 ~¢'~AFF' ROAD <br />AUM~VI LLE <br /> <br />:USE OF BUILDING: <br /> <br />OR 9?325 <br /> <br />CONTRACT CITY UGB <br />~,RiON COUN'I Y NO <br /> <br />: MAILING ^DDRESSz <br /> <br />CATEGORY. <br /> coMr4ERCiAL <br /> <br />OCCUPANCY: <br /> <br />OCCUPANT LOAD <br /> <br />PHONE: ?43-2844 <br /> <br />..... / SL~CK: ~SECTION. TOWNSHIP <br />LOT; <br /> <br />WIDTH: DE~TH; AREA; UNiTSI <br /> <br /> SITE NUIVlBER: 92-018¢? <br /> VALUATION: <br /> <br />RANGE ZONE <br /> <br />RSEG LOC CORNER: <br /> NO N(.) <br /> <br />MAP, <br /> <br />TYPE: ELEC'f'R [CAL <br /> <br />CONI'RACI'OR, NO. 45933 <br />LICENSE NO: <br /> Pacff¢ffc Coast E'le¢~nff¢ <br />PO Box 851 <br />~yt;on, 9?383-0009 <br />PHONE: 789-7671 <br /> <br />PERMIT OR APPLICATION NO: 39980 <br /> <br /> SUPERViSiNG ELECTRiC[AN/NUMBER <br /> <br />SERV[CE/ffEEDER LE~ THAN 200 ANPS <br />ELECTRICAL STATE SURCHARGE <br /> <br />PAYEE: Pa¢i¢i¢ OOa~ E']ectric:In¢ <br />RECEIVED BY; E~42 <br /> <br />QUANT[fY A~DUN'I <br /> ~ $50_00 <br /> $~.~0 <br /> <br />TOTAL ~E~LSEO FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />$62.50 <br /> $0.00 <br /> <br />BALANCE OUE $0.00 <br /> <br />RECEIPT NO: 42022 <br />TYPE: CK CHECK ~: 5902 <br /> <br />$ THIS iS A VALID PERI, IT $ THIS PER~41T EXPIRES 180 DAYS FI;~I~I ITS i~£ OATE. iF <br />CONSTRUCTION CEASES FOR A PERIOD OF 180 DAYS, OR iF CONSTRUCTION FAILS TO ~EET ALL <br />RE. QUiRES,lENTS OF STATE LAN~ AND tfARiON COUNTY BU[LDING AND ZONiN~ ORDINANCES, THIS PER/VllT <br />,~rlALL BECOfflE NULL AND VOID. <br /> <br />REMARKS: 125 AMP SERVICE ~ t <br />DONALD E. ~OODLEY, MARION COUNTY BUILDING OFFiCiAL / BY ....................................................................../~ <br /> <br />OFFICE COPY <br /> <br /> <br />