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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 8:00 - 4:$0 <br /> 24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am a registered buildor OR ( ) the authorlzed representative BI,MATt.mE OF APPLICA <br />of a registered builder, <br />The wo$'k wilt be performed by a re~listered builder, <br />Other <br /> <br />DORAl I,~ ............. <br /> <br /> .,861 S NEWMAN RD <br /> PI'iONE~ 6~4"-2768 VAI.,LJAT~SN; <br /> <br />TYPE.' ELECTRICAL <br /> <br />CON f kA[.,Tf,~I'~ ~ NO,, <br />LICENSE <br />~ 0 R A H ,~ J I M <br />~86:[ S NEWMAN RD <br />WDBN., OF( <br />PHONE: 6S~-'276~ <br /> <br /> ITEM <br />SERVICE;/PEEI)ER L, ES[~ THAN 2B8 AMPS <br />ELECTR:[CAL STATE SURCHAR(;E <br /> <br />PERMIT OR APPLICATION NO: 4&18] <br /> <br /> SUPERVISING ELE(:TR Z C]:AN/NIJMBEF;~ <br /> <br />C;~UANT I 'f'Y AMOON'T <br /> <br /> T£tTAL ASSESSED FEES $52,,50 <br /> PRI~V.TOI.JS RECEIPTS $0.06~ <br /> THIS RECEIPT ¢~;2.58 <br /> BALANCE DUE $8. ~ <br /> <br /> PAYEE: DSRAI% J'.[H Jd:.[.,EJ, i-T ~0, 48515 <br /> RECIEZ[VED BY: CE.. _ .......................................................................................... TYt::'E~ CK CHECK ~1:: 5864 <br /> <br /> * TH~S ~S A VALID PEEMtT ~ THIS PERMIT EXPIRES 188 ~AYS FROM ITS ISSUE DATE. ZF <br />CONSTRUCTION CEASES FOR A PERIO~ QF 188 ~AYS~ OR ~F CONSTRUCTION FAILS TO MEET ALL . ~ <br />REQUIREMEHT8 OF STATE LAWS AND MARIUN COUNTY BUILOIH6 ANB ZONIN~ ORDIHANCES~ THIS PERM.~T <br />BHALL BECOME NULL AN~ VOI~. <br /> <br />kc. MAi t,,~,, ,:,[.,V CFI(;. FROM WSODSHE)) TO I-[OUSE I_OCAI"'' .... <br /> <br />DONALD E,, ~(:I£IDL,E:Y~, MARION COUNTY )~)U'~:LDZI',I(,'; [t,-F1, CJ, AL, / BY .......................................................................... <br /> <br />FO~M ¢ ,~c ~s-~ ~[v. 4/~o OF FICE COPY <br /> <br /> <br />