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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OI~EGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br /> 24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />1 am a registered builder OR ( ) the authorized reptosentati¥e SIGNA'rUR~ OF APPUCAN 'Z'° ¢~. ¢~¢'¢' <br />of a registered builder. <br />The work will be performed by a registered builder. <br />Other , <br /> I have read ~nd aOf¢e to the terms sta(ed on the reverse sfde of bATE; <br /> <br /> ' ':~- t._,. 00. :1:8 <br />ow~cg; DAle., 0~/08/93 TINE." <br /> <br /> JOHNSON, SHIRLEY A. <br />~tTIJS AQDRESS: <br /> <br /> TAX LO'f; CATEGORY: <br /> <br /> RESZl)EM'rIAL <br />CONSTRUCTION ~YPE: OCCUPANCY: <br /> <br /> 87~4 MILL CREEK RI) SE 86~*'~^STCif'/; , uae: <br />AIJMoVILI.,E.~ OREGON OR ~7~25 MARION COUNTY, NO <br /> <br />CONTACT DAUGHTER SANDRA 749-1111 <br /> SITE NUMBER: <br />PHONE: 749-2681 VALUATION: <br /> <br />35. AC NO .... NO <br /> <br />TYPE: ELE~TRIGAL <br /> <br />CONTR,,A, CTOR~ NO,, <br />LICENSE NO: <br />,~.~OHNSOI,I~ 81-ilRLEY A,, <br />CONTACT IDAUGHTER ~AN1DRA 749-11.1 <br /> <br />PI,.IONE ~ 74~.-2601 <br /> <br /> ITEM <br />SERVICE/FEEl)ER LESS THAN 200 AMPS <br />ELECTRICAL STATE SURCHARGE <br /> <br />PERMIT OR APPLICATION NO: 4~714 <br /> <br /> SUPERVISING ELECTI;IICIAN/NUMBER <br /> <br />TOTAL ASSESSE~ FEES <br />PREVIOgS RECEIPTS <br />TMIS RECEIPT <br /> <br />QUANTITY AMOUNT <br /> 3 $150.00 <br /> $7,.50 <br /> <br />· M.,.¢ 7. o0 <br /> $157.50 <br /> <br />BALANCE DUE $0.00 <br /> <br /> PAYEE= JOI,,INSON~ SHIIBLEY A. RECEIPT NO: 52079 <br /> RECEIVED BY: DM2 ............................................. TYPE: CK CHECK ~: 2790 <br /> <br /> $ THIS IS A VALID PERMIT $ THIS PERMIT EXPIRES 18~, BAYS FROM ITS ISSOE DATE. IF <br />CONSTRUCTION ~EASES FOR A PERIOD OF 188 DAYS, OR IF ~ONSTRU8TIQN FAILS TO MEET ALL <br />REQUIREMENTS OF STATE LAWS AND MARION COUNTY BUILDING AND ZONING ORDIHANCES, THIS PERMIT <br />SHALL BECOME NULL AND VOI~. <br /> <br />RLMARk,.>., 1 SERVICE ~ 2 FEEDERS ~7 <br />DONALD E. W00DLEY, MARION COUNTY BUILDINF~ OFF.~CIAL / BY ............................................ ~_ <br /> <br />OFFICE COPY <br /> <br /> <br />