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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 performing work on a property I own or occupy, <br /> <br />haw-,' read and agree to the terms stated on the reverse side of <br /> <br />SIGNATURE OF APPLICANT; <br /> DATE'. <br /> <br />TINE: t~: 57::[8 TAX LOT: <br /> <br />CONSTRUCTION T~PE; <br /> <br />' CATEGORY~ <br /> OCCUPANCYZ <br /> <br /> [;)724 &[)LF' CLUB <br />AUNSV];LLE <br /> <br /> SE ' ~ONTRACT CITY: UGS: <br />OR 97325 MARION COUNTY <br /> <br />LOT: <br /> <br />TOM & SHIRLEY BECKE,~ <br />:[24,44 W,, S'T'AYTON RD AUHSVILLE SITE HUMBLE-- 9;~-81974 <br />PHONE: 769-'3304 VALUATION: <br /> <br /> 8LOOK: SECTION'. TOWNSHIP: ~ANGE: ZONE; <br /> <br />MAP: <br /> <br />75. AC <br /> <br />NO NO <br /> <br />48 <br /> <br />TYPE: ELECTHICAL <br /> <br />CO?!'l F~ACTOR, NO. 18875 <br />L,I£,EFISE NO: <br /> £,h(~,rry !,:l,'t'y Electric ]',nc <br />F'O Box 12668 <br /> <br />PHONE: <br /> <br />PERMIT OR APPLICATION NO: 47252 <br /> <br /> SIJPECWI S]:N6 ELECTR I C I A ,I/14UNBI~:F¢ <br /> <br /> I 'l' E H <br />F'OHP OR IRI~::[E. AT:rON CIRCLE <br />E[,.Ec'rI:~CAL 9TATE SURCHAE[;E <br /> <br />PAYEE': Cherry C?;y IFiectric :mc <br />R ,ri' ' . <br /> ,ECIL,,VED BY., <br /> <br />TOTAL ASSESSED FEE,~ <br />F'REV];OUS RECEIPT.C; <br />THIS RECEIPT <br /> <br />BALANCE DUE <br /> <br />QUAI,ITITY AMOUNI' <br /> 3 $1~_0,00 <br /> $6 ,, 8,8 <br /> <br />RECE,[FI <br /> <br />$('I ,, 00 <br /> <br />4?509 <br /> <br /> TYPE: OK CHECK <br /> * THIS IS A VALID PERMIT * THIS PERNIT EXPIRES 188 DAYS FROM ITS ISSUE DATE. IF <br />CONSTRUCTION CEASES FOR A PERIOD OF 188 DAYS, OR IF CONSTRUCTION FAILS TO MEET ALL <br />REQUIREMENTS OF STATE LAWS AND MARION COUNTY BUILDING AND ZONING ORDINANCES, THIS PERNIT <br />SHALL BECOME NULL AND VOID. <br /> <br />FLMARh,,h, 3 IRRI£.~A'fZOI,f PUMPS OI,[LY <br /> <br />DONA[..):) f.,T.,. WOODL, I~Y,~ HARION COUNTY 90ZLD,1:N60FFICZ~L / BY <br /> <br />FORM # MC '1 ~-~. RSV, 4/BO OFFICE COPY <br /> <br /> <br />