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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO, 225 <br />220 HIGH STRBET 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 8m performing work on a property I own o¢ occupy, <br /> lamare,.gi~teredbuilderOR( )thesuthonzedrepresentative <br /> of a registered builder, <br /> 'the work wilt be performed by a registered budder, <br /> Other <br /> I have read and agreo to the terms stated on the reverse side of <br /> this document, <br /> <br /> DATE: 08/12/92 TIME: 16:17:57 <br />OWNER: <br /> ARESTAD, BRUCE <br /> <br />SITUS ADDRESS'. <br /> <br />SIGNATURE OF APPLICANT <br /> <br /> DATE: <br /> <br /> TAX LOT <br /> <br /> CONSTRUCTION TYPE <br /> <br /> 13102 ARNOT ROAD NE <br />AURORA OR 97002 <br /> <br />CONTiI~]~: CO~JNqH~S: NO <br /> <br />O~E OF 8UILOINGZ <br /> <br />iMAIL}NG ADDRESS: <br /> <br /> SAME <br /> <br /> PHONE: 678-5158 <br /> <br />SUBD VISION; <br /> <br />SITE NUMBER: <br />VALUATION: <br /> <br />LoT; BLOCK; <br /> <br />WIDTH: DEPTH: <br /> <br />SECTION TOWNSHIP: RANGE <br /> ,5 48 <br />A..^ 2#_"'TS AC RRE s <br /> <br />CATEGORY <br /> RESIDENTIAL <br /> <br />OCCUPANCY <br /> <br />DCCUPANT LOAD <br /> <br />92-02733 <br /> <br />EFL 5 <br />NO <br /> <br />TYPE: ELECTRICAL PERMIT OR APPLICATION NO: <br /> <br />41500 <br /> <br />CONTRACTOR, NO. <br />LICENSE NO: <br />ARESTAO~ BRUCE <br />SANE <br /> <br />SUPERVISING ELECTRICIAN/NUMBER <br /> <br />PHONE: 678-5158 <br /> <br /> ITEM QUANTiTV AMOUNT <br />BRANCH CIRCUIT, WITHOUT SERVICE OR FEEDER - 1ST CIRCUIT i $$5.00' <br />BRANCH CIRCUIT, WITHOUT SERVICE OR FEEDER EACH ADDITIONAL 6 $12.00 <br />ELECTRICAL STATE SURCHARGE <br /> <br />TOTAL ASSEBBEO FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />$49.55 <br />$49.B5 <br /> $0.00 <br /> <br />BALANCE DUE $0.00 <br /> <br />PAYEE: RECEIPT NO: <br />RECEIVED BY: P8 ..................................... TYPE: CHECK ~: 0 <br /> <br />· THIS iS A VALID PERMIT · THIS PERMIT EXPIRES 180 DAYS FROM ITS ISSUE DATE. IF <br />CONSTRUCTION CEASES FOR A PERIOD OF ~80 DAYS, OR IF CONSTRUCTION FAILS TO MEET ALL <br />REQUIREMENTS OF STATE LAWS AND MARION COUNTY BUILDiN8 AND ZONING ORDINANCES, THIS PERMI'~ <br />SHALL BECOME NULL AND VOID. <br /> <br />REMARKS: 7/CIA <br />DONALD E. WOODLEY, MARION COUNTY BUILDING OFFICIAL / BY ........... F/~._ .................................... <br /> <br /> OFRCECOPY <br />FORM # MC 15-56 REV, 4~ <br /> <br /> <br />