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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 /> 24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I r~m performing work on a property I own or occupy. <br />I am a registered builder OR ) the authorized representative SIGNATURE OF APPLI <br />of a registered bul~der. <br />The work will be perCormed by a registered builder, <br />Other ...... <br /> <br />OWNSR= DATE: 0AI3019S TIME: <br /> <br />QATSGORY; <br /> <br />77,.~ HiLL CREEK RD <br /> <br />SE <br /> <br />CONSTRUCTION TYPE: <br />CONTRACT CITY~ UGB; OCCUPANT <br /> <br />USE OF gUlL1 <br /> <br />MAILING <br /> <br />SUBDIVISION: <br /> <br />PHOHE: 749-2071 <br /> <br />LOT; SECTION'. TOWNSHIP'. <br /> <br />SITE NUMBER: 93-0227~ <br />VALUAT~ON~ <br /> RANGE: ZONE: <br /> <br />WIDTH; ~EPTH; AREA'. UNITS; <br /> <br />IRREG. LOT; CORNER; <br /> <br />TYPE= ELiECTRICAL <br /> <br />CONTP.,A. C'f OR~ NO,, <br />LICENSE <br />,John A Sisera" <br />10764 Hill. Cree~ <br /> <br />PHONE.: 749-2971 , <br /> <br />PUMP OR ~RRIGATIOH <br />ELECTRICAL STATE SURG "' <br /> <br /> PERHIT UR APPLIOATION NO: 4816~ <br /> <br />0S964 SUPERVISING ELE-CTRICIAH/NUMBER <br /> <br />QUANT I TY AHOUHT <br /> :L $40.80 <br /> $2,00 <br /> <br />PAYEE:, .John ASpeer <br />RECEIVED BY: PM <br /> <br /> RECEIPt <br />P~: CK CHECK <br /> <br /> * THIS IS A VALID <br />CONSTRUCTION CEASES <br />REQUIREMENTS OF STATE <br />SHALL BECONE NULL AND <br /> <br /> REMARKS: IRR P~P ~::::'~ .............................................................. <br /> <br />$42,00 <br /> <br />$4..00 <br /> <br />50454 <br /> 1247 <br /> <br />ITS ISSUE DATE. IF <br /> FA T NEE A L <br /> <br />DONALD E. WOODI,,,EY, <br /> <br />MA{ION COUNTY I~U~£DIqG O:FICr~L / BY ....................................................... <br /> <br />FORra # ~C t ~-~ R~. ~ OFFICE COPY <br /> <br /> <br />