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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 am a registered buUdOr OR [he authorized rep,esen a ire S G N ATU R E O F A p p L CA NT .~[/¢~"~/~'~¢.._ ~//~ ~'- <br />T~ ~ae.~r~ ~ ~i~ ~ t~ e.b ~ ~ rdf~r~:m ed by are9 istered buildel. <br /> <br />OWNE~ATE: 04/06/92 'f'iME: 12 i 53.* 29 <br />S~tus ^PeRi-'SS~Y' R'ONALO <br /> <br />TAX LOt; <br /> <br />, CATEGORY: <br /> OCCUPANCY: <br /> <br />DENT IAI <br /> <br /> CONTRACT CITY: UGB: : OCCUPANT LOAD; <br /> 62?3 ~HAW LANE BE <br />AUMSV I LLE OR 9 '! 325 . <br /> <br />PHONE: 749~2553 SiTE NUIV~ER: 92~00560 <br /> <br />1-..4t AC ...... ,NO: NC) <br /> <br />MAP; <br /> <br /> 51 <br /> <br />TYPE: ELECTRICAL <br /> <br />CON'['RAC'FOR, NO. <br />LZ CEN~.E NO: <br />F4CCOY, RONALO <br /> <br />PERNIT OR APPLiCATiON NO: 39186 <br /> <br /> f:SLIpERvtBING ELEC'rRICiAN/NU~IBER <br /> <br />PHONE: 749-2553 <br /> <br /> i'rDVl <br />~ERVICE/FEEDER LESS THAN 200 ANP3 <br />BRANCH CiRCUiT, ~iT'H ~ERViCE OR FEEDER <br />ELECTRICAL STATE SUf4CHARGE <br /> <br />QUANTi'f'Y AMOUNT <br /> $50.00 <br /> <br /> $2.?0 <br /> <br />TOTAL A[5.~D FEES <br />PREVIOUS RECEIPTS <br />I'HIS RECEIPT <br /> <br />$56_?0 <br /> $0,00 <br />$55.70 <br /> <br />BALANCE DUE <br /> <br />RECEIPT NO: 41210 <br />TYPE: CK CHECK ~: 290 <br /> <br />PAYEE: MCCOY, RONAL0 <br />RECEIVED BY; ~ <br /> <br />~ THi~ iS A VALID PEI~iT * THIS PE~4IT EXPIRE.~ 1BO DAY~ FR~ iTS i~(_<AJE DATE. IF <br />CONSTRUCtIOn/ CF_A~ FOR A PERIOD OF ~80 DAYB, OR IF C(]NSTN~UCTION FAiL~ TO MEET ALL <br />R~-QUIREF4ENTS OF STATE LAIN(3 AND ~4ARION COUNTY BUiLDiNG AND ZONING ORDiNANCe, l'Hl~ PEf~iT <br />:DHALL BE~:~A~IE NULL AND VOID. <br /> <br />REMARKB: 1/200ANp$ 2 CiR <br /> <br />DONALD E_ INOODLEY, R~RIGN COUNTY BUILDING OFP'iCIAL / BY <br /> <br />OFFICECOPY <br /> <br /> <br />