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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HiGH STREET NE <br /> SALEMt OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00- 4:30 <br /> <br />I am performing work on a property I own or occupy. <br />I am a registered builder OR the authorized representative S~GNATURE OF APPL CANT ,~, <br /> of a registered builder, <br />The work will be berformed by a registered builder. <br />Other. <br />I have read and agree to the terms stated on the reverse side ot DATE: ............... <br /> <br />: MUI' CH, JAMES ..................... !. _.56.41B-.080 ............ RESIDENTIAL <br /> <br /> 1~5~4 MILL CREEK RD SE : <br />: AUMSVILLE OE 97325 ~ MARION COUNTY NO <br /> <br />~ SAHE <br /> SITE NUN~R: <br />,' PHONE ~ ; VAL UAT ~ ON: <br /> <br />TYPE: ELECTRICAL PERHIT OR APPLICATION NO: 48435 <br /> <br />CONTRACTOR~ NO. 92801 <br />LICENSE NO: <br />Charles V Kem <br />1196 ~Sth Ave NE <br />Saler~, 97~01-0000 <br />PHONE: 364-9267 <br /> <br />SUPERVISING ELECTRICIAN/NUMBER <br /> <br /> ITEH <br />SERVICE/FEEDER LESS THAN 200 AMPS <br />ELECTRICAL STATE 8URCNARGE <br /> <br /> QUANTITY <br /> 1 <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />BALANCE DUE <br /> <br /> AMOUNT <br /> <br /> $2.50 <br /> $52.50 <br /> $0.00 <br /> $52.50 <br /> <br /> $0.00 <br />50744 <br /> <br /> PAYEE: Charles V Kem RECEIPT NO: <br /> RECEIVED BY: PM TYPE: OK CHECK ~: 17889 <br /> <br /> * THIS IS A VALID PERHIT A THIS PERMIT EXPIRES 188 DAYS FROM ITS ISSUE DATE, IF <br />CONSTRUCTION CEASES FORA PER[OD OF 188 DAYS, OR IFCOHSTRUCTION FAILS TO HEET ALL <br />REQUIREMENTS OF STATE LAOS ANDMARION COUNTY BUILDING AND ZONING ORDINANCES~ THIS PERMIT <br />SHALL BECOME NULL AMD VOID. <br /> <br />REMARKS: SER <br /> <br />DONALD E. WOODLEY, <br /> <br />MARION COUNTY B[JILDING OFFICIAL / BY <br /> <br />~oR~ ~ ~c t s.r~.~,. 4/~o OF FICE COPY <br /> <br /> <br />