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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 -, 4:30 <br /> 588-7904 <br /> 24 HOUR CODE-A-PHONE: <br /> <br />I am a registered builder OR ( ) the authorized representative SiGMA'lURE OF APPLICANT: <br />of 8 register'ed builder, <br /> <br />Other <br /> <br />I)ESIRE;E I-.IERF(MANN -,. HOB:I;I.E OWNER <br />9,.;34 SHAW SQUA1AE RD SI-'," AUMSVILLE <br />PHONE: 364,.,.13~g <br /> <br />SITE NUMBER: 93-80??5 <br />VAI.,IIAT I ON: <br /> <br />TYPE: ELECTRICAL <br /> <br />CONTRA[:TOR NO,, <br />LICENSE NOs <br />HERRM¢.4qN,~ <br />DESiEEE HZR2~ANN - ~OBILE OWNER <br />9~54 ~HAW SQUARE RD SE AU~SV~I.L <br /> <br /> ITE~ <br />SERVICE/FEEDER LESS TFIAN 288 AMPS <br />BRAI,~CH CIRCUIT. W~ll-I.SEF(V;[CE [)R FLEDER <br />ELECTRICAL STATE SURCHARGE <br /> <br />PERMIT OR APPLICATION NO: 4§939 <br /> St)PER¥ISIflG E}.E-C'I'RI'CL(AN/NUMX ER <br /> <br />TH]:S RECEIPT <br /> <br />QUANT ]:TY <br /> 1 <br /> 1 <br /> <br />BALANCE <br /> <br />AMOUNT <br /> $50.00 <br /> $2.00 <br /> $2.60 <br /> <br /> $54,,80 <br /> $0.00 <br /> <br /> PAYEg~ HERRfiANN, ROY ~R,:CE~F.~ NO: 4814~ <br /> RECE:~¢ED BY: F'M ..................................................................................... TYFE: CA' CRE~K ~. <br /> <br /> * THIS IS A VALi~ PERMIT * THIS PERMIT EXPIRES 188 DAYS FROM ITS ISSUE DATE. IF <br />CONSTRUCTION CEASES FOR A PERIOD OF 18~ DAYS. OR IF CONSTRUCTION FAILS TO MEET ALL <br />REQUIREMENTS OF STATE LAWS AND MARION COUNTY BUILDINGANB ZONING ORDINANCES, THIS PERMIT <br />SHALL BECOME NULL AND VOI~~ <br /> <br />REMARKS: SER <br /> <br />DONALD E,. WOODI..EY~ HARION COIJNTY BUILD]:NG OFFICIAL / BY <br /> <br />FORM # MC 1 $.5~ n~, 4/~0 OF FICE COPY <br /> <br /> <br />