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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH S~[pEET'NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:80 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I 8m a registered builder OR the authorized representat ve <br /> <br />I have read and agree to the terms stated on the reverse side of <br />this document. <br /> <br />SIGNATURE OF APPLICANT; <br /> DATE'. <br /> <br />TAX LOT: <br /> <br />CONSTF JCTION TYPE <br /> <br />CONTR~ 3T ClTY~ UGB, <br />HARION COUNTY ,K) <br /> <br /> 8294 I')I_NEY RI) SFi <br /> AIIFiSV:[I. I. F <br /> <br />MAILING ADDRESS: <br /> <br />OR 97t525 <br /> <br />2ATEGOnY <br /> <br />OCCUPANT LOAD' <br /> <br />LOT: <br /> <br />f HOII <br /> <br />SECTION'. [OWNSHIP <br /> <br />SITE NUHBER.- 93~tile227 <br />VAL. U A T ]: ON: <br /> RANGE ZONE <br /> <br />MAP' <br /> <br />WIDTH: DEPTH. AREA: JNITS; <br /> <br />RREG. LO7 CORNER <br />bI ' Kfl <br /> <br />TYPE: ELECTRICAL PERflTT OR APPLTCATI~IN <br /> <br />C[II,I1RA¢"I 0R.¢ 140. 244604 <br />L.'.t'.CENSE <br />Juch>,o¥1tE :[fie <br />F'O l~lox <br />~,~a 1 m,% 9'73~9-(5000 <br />i~: FIONE: ~6:~-4 t 4 :L <br /> <br />SIlI='FRV l,~il Il,It; L:]..EC T FC[C :[ AN/I,IUM B[::R <br /> <br /> I l' EH [It.lA141' ] TY AHOUNT <br />[IRAN,C.,Jt C'[RCIJ'[T,~ tJ~THOUT SE~V~[ OR FEEDER - 1ST CZRC, IJIT 1 <br />BliAI,I[J,I C]]tCI, IIT~ WITHOLIT SERVICE OR FEEDEFt EACH A~DITIIZII4AI,, 1 <br /> <br />TOTAL ASSESSEI) FE, L,,,, <br />PREY IOU.°', kE.[,EIP I S <br />TH]'S RI;_:. C. IE I P'F <br /> <br />$,~8,8,,~ <br /> <br />BAI_ANBE DUE $0,, 00 <br /> <br /> PAYFE;~ Judsomi~ Inc RECF:[PT NO: 478:1;?i <br /> <br /> * THIS I8 A V~I. ID PERHIT * THIS PERHIT EXPIRES 188 DAYS FROH ETS ISSUE DATE. <br /> <br />REQU~REHEHTS OF STATE L~S AND NARIOfl COUHTY B:UILDIHG AND ZONING ORDINANCES. THIS PERHIT <br />SHALL ~ECOHE HULL RN~ <br /> <br />t[..HAMx ...... CIR <br /> <br />:OONAl..l) I? .. WDOI)L FY,, HAR~Ob! COLIN'IY BUi[Lt(YH'I(,,. OFFICIAL. / BY <br /> <br /> <br />