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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLOG, 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 />of a registered builder. <br /> <br />have read and agree to the ~erm$ 8ta~ed on the reverse side of <br />thio document· <br /> <br /> CATEGORY; <br /> RE.: ]. g'~;. ,il /4 ... <br /> <br />,OOOUPANCY; <br /> <br />"d~E 6¢ ~UI'LD'{AG~ , NO. OF 8EOROOMS <br /> <br /> 1:I. 6U4 BUNT]:NG L.N J <br /> ::'I-If;NE:: 678-2219 : VALUATION: <br /> <br />,[8~;. ~[58E[ ............................~ SECTION: ,TOWNSHIP:: ; RANGE: ' ZONE: 'MAP: <br /> J ~ 11 , 4S 1W , AR ' 3 <br /> <br />TYPE: ELECTRt6AL <br /> <br />CONI'RACI'OF:,j NO, <br />LICEI'ISE NO:: <br /> <br />:1,:i.~54 ~.:IUNT:I:H6 LN. <br />ALIRDRA.¢ OR ~7r/~02 <br />PHOIIE; 678---22!~ <br /> <br />PERMIT OR APPLICATION HO: 569~5 <br /> SUPERVISTNG ELECTklC,[AN/NUMBER <br /> <br /> I'rEM <br />MANUFAC'~'URE~) HOME SERVICf_';/FEE~ER <br />ELECTF~ZCAL STATE SURCHARGE <br /> <br />QtJANI'ITY AMOUNT <br /> t ~;40. <br /> <br /> TOTAL AS,:~E,rx.~:.D"~' '~'c'" FEES <br /> PREVIOUS RECEIF'T~: <br /> THIS RECEZPI" <br /> <br /> , <br /> RIECEIF'T NO: <br />PAYEE~ TYPE: CHECK <br />~;5CEIVE~ BY~ <br /> <br />$42 ,, f¢i¢) <br /> <br /> ~ THIS IS A YALI~ PERMITS THIS PERMII EXPIRES::188 ~AY$ FROM ITS iSSUE DATE. IF <br />CONSTRUCTION CEASES FOR A OR IECONS~RUCTIUN FAILS TO MEET ALL <br />REQUIREMENTS OF ~TATE ORDINANCES, THIS PERMZT <br />SHALL BECOME HULL AN~ VOIO~ <br /> <br />REMARKS: MS SVC <br /> <br />DOI,IAt..I) ~i:r, I'I~;]ODt--E'~'~r MAPJ;ON COUNI'Y 'F~tJII.DING OF?-'J;CIAL / BY <br /> <br />OFFICE COPY <br /> <br /> <br />