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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SAL~:M, OREGON 97301 <br /> <br /> PHONE:588-5147 8:00- 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am performing work on a property I own or occupy. <br />I am 8 rag{stared builder' OR ( ) the authorized remosentative <br />of a registered builder, <br />The work will be performed by 8 registered builder, <br />Other. <br />I have read and agree to the terms stated on the reverse side of <br /> <br /> OATE: 09/09/92 TIME: <br />'OWNER: <br /> LAKEWOOD UTILITES LTD <br /> <br />SITUS ADDRESS: <br /> <br />7:15:17 <br /> <br />YAX LOT <br /> <br />¢ONSTRUOTION TYPE: <br /> <br />CATEGORY: <br /> COMMERCIAL <br /> <br />OCCUPANCY; <br /> <br /> 15269 DAIQUIRI LAKE DR NE <br />AURORA OR 97002 <br /> <br />C6T uNT¥ , <br /> <br />USE Of I~UILDING <br /> <br />MAIL~NQ ADDRESS: <br /> <br />P.O. 71 <br />SALEH, OR 97309 <br />PHONE: 244~4562 <br /> <br />BITE NUNBER: 92-02907 <br />VALUATION= <br /> <br />LOT: 8bOCK S~CTION' <br /> 22 <br />20 83 <br /> <br />TOWNSHIP: RANGE ZONE. <br /> 4S 1W RS <br /> T~ ~REG, LOT: CORNER <br />UN[ <br /> "~= YES NO <br /> <br />TYPE: ELECTRICAL <br /> <br />CONTRACTOR. NO. 00458 <br />LICENSE NO: <br /> CHRISTENSON ELECTRIC INC. <br />i11 sw COLUMBIA ~480 <br />PORTLAND, 9720i <br />PHONE: 241-4812 <br /> <br />PERNIT OR APPLiCRTION NO: 42429 <br /> <br /> SUPERVISING ELECTRICIAN/NUMBER <br /> <br /> ITEM <br />SERVICE/FEEDER LESS THAN 200 AMPS <br />BRANCH CIRCUIT, WITH SERVICE OR FEEDER <br />ELECTRICAL ST4TE SURCHARGE <br /> <br />PAYEE: CHRISTEN$ON ELECTRIC INC. <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br />BALANCE DUE <br /> <br />QUANTITY AMOUNT <br />5 $250.00 <br />7 $z4.00 <br /> $13.20 <br /> <br />RECEIPT NO: <br /> <br />$277.20 <br /> $0.00 <br />$277.20 <br /> <br />$0~00 <br /> <br /> 44498 <br />RECEIVED BY: OM2 TYPE: CK CHECK ~: 13~28 <br /> <br />· THIS IS A VALID PERNIT · THIS PERN%T EXPIRES !80 DAYS FROM ITS ISSUE DATE. IF <br />CONSTRUCTION CEASES FOR R PERIOD OF [SO DAYS, OR IF CONSTRUCTION FAILS TO NEET ALL <br />REQUIRENENTS OF STATE LR~S AND NARION COUNTY BUILOIR6 AND ZONIN6 ORDINANCES, THIS PERNIT <br />SHALL BECONE NULL AND VOIO. <br /> <br />REMARKS: 5 SERVICES/7 CIR <br /> <br />DONALD E. WOOOLEY, NARION COUNTY 8UILDIN6 OFFICIAL / BY <br /> <br />FORM # MC 15,56 REV. 4/90 OFFICE COPY <br /> <br /> <br />