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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />9';'0 HtGH STREET NE <br /> SALEM, OREGON 97.,3,01 <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 />I am a registered builder OR the authorized representative <br />o aregistered bu der, <br />The work will be performed by a registered builder. <br />Other <br /> <br />:OWN~rE: 08/'15/9q <br /> ALLENBY,¥'HOIV~AS H <br /> SITUS ADDRESS: <br /> <br /> 10378 CHAMPOEG ROAD NE <br />AURORA OR 9?002 <br /> <br />MAILING ADDRESS: .... <br /> <br /> TAX LOT: <br /> <br /> CONSTRUCTION TYPE: <br /> <br /> CONTRACT CITY: <br /> <br />tViAf,~ l ON COUN']'Y <br /> <br /> SUBDIVISION: <br /> <br />4024'/'~000 ! RESI DEN I LAL <br /> NO <br /> <br />PHGNE: 678'-2258 <br /> <br />DEPTI4: <br /> <br /> TYPE: ELECTRICAL PERMi'~ OR APPLiCAf'iON NO." 34516 <br /> <br /> CON'~RAC'iOR, NO. 4204-? 5UP~R¥1BiNG ELECI'RI. CIAN/NUI'~SBR <br /> LICENSE <br /> 'IQDB KENAGY ELEC'fRiC <br /> '] 'f '1 N~ ~ND ~'f'REE'f' <br /> C:~BY, OREGON 97013 <br /> <br /> i f' EM {~UAN f' I TY A~OUN T <br /> BRANCH C~RCUI'f'~5 - 'fWD TO IEN ~ $50,00 <br /> ~_ECfRJCAL ~f'ATE SURCHARG~ $2_50 <br /> <br /> TO'FAL A~E~ED P~ES $52_50 <br /> PREVI~S RECEIPTS $0_00 <br /> 'FHtS RECE&P'f' $52.50 <br /> <br /> BAL,~CE ~tE $0. OS <br /> <br /> PAYEE: TODD K~AGY ELECTRIC RECEiP'/ NO: 36393 <br /> RECEIVE[} BY: OM2 ................................................................................................................ TYPE: CM CH~CR ~: 3905 <br /> <br /> $ THiS 18 A VAL[O ~IT $ TH[8 P~IT ~PIR~ 180 ~ F~ <br />~$T~CJI~ C~ FOR A ~[OD 0F 180 ~Y~, OR [E ~)'~CTI~ FAI~ TO ~EET ALL <br />~iR~T~ OF STATE ~ ~D:~R[~ ~NTY BUELDiNG ~D Z~ING OR~IN~C~, THi$ ~11" <br />~ALL B~E NULl_ ~D <br /> <br />f'<EMARK~t 2-10 C;iR <br /> <br />F..)ONALD E- WQGDLEY, <br /> <br />MARION COUNYY BUILDING OFFiCiAL / BY <br /> <br />FORM # MC 15-56 REV, 4/90 OFFICE COPY <br /> <br /> <br />