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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NjE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 588-5147 <br /> CODE-A-PHONE 4:30 P.M. - 8:00 A.M. <br /> <br /> I am performing work on a property I own or occupy· <br /> lam a registered budder OR( ) the authorized representative <br /> <br /> Other <br /> I have read 8nd agree to the terms stated on the reverse side of <br /> <br />DATE: 09/12/88 TI~: 3: 96: ~.~.~... <br /> <br /> ALLENBY, TON <br /> <br /> 10378 CHANPOEG ROAD NE <br />AURORA OR 97002 <br /> <br /> TAX LOT CATEGORY: , <br /> RESIDENTIAL, <br /> <br /> CONSTRUCTrON TYPE OCCUPANCY' <br /> <br />'-~NTRACT ~1+~i ........ JOB: I OCCUPANT LOAD'. <br />MARION COUNTY NO <br /> <br />MAILING ADDRESS: <br /> <br />SUBDIVISION: <br /> <br />PHONE: <br />LOT: <br /> <br />678-2258 SITE NUMBER ~ ~ <br /> VALUATION: <br /> 1 BLOO~<: ....... SEC'T[dN ~-~v~h~F: .................. ~'~ ............ ~"~>~4 ~: .............. ~'~'~: <br /> 6 4$ 1~ ~ 4 ' E~ <br /> '~DEPTH:j '' ' AREi .................................................. 5 . 00000 ~NITS ~ ~&;'"~i; ...........Y~ ]~;%~NO ..................... <br /> <br />TYPE: ELECTRICAL <br /> <br />CONTRACTOR, NO. <br />LICENSE NO: <br />ALLENBY, TON <br /> <br />PERNIT OR APPLICATION NO= ~ <br /> SUPERVI~]~.~-CTRICI/~4/NUNBER <br /> <br />PHONE: 678-2258 <br /> <br /> ITEN <br />TNO OR MORE NEN OIRCUITS~ALT OR BXT <br />FLEET SURCHARGE -ZONE 6 <br />ELECTRICAL STATE SUf~_,HARGE < :: :, :: <br /> <br /> ~ ', <br /> <br />PAYEE: ALLENBY, ROSANNE <br />RECEIVED BY: JB <br /> <br />* THIS IS A VALID PERNIT: <br /> <br />CONSTRUCTiON CEA~ FOR A! <br />REtIREmENTS Of STATE <br />,SHALL BEO0~E NULL ,N'4D <br /> <br />RENARKS: <br /> CIRS R# 4823 ;~', <br /> <br />DONALD E. NOODLEY, MARION COUNTy /~iLDING "' <br /> <br />FEES <br /> <br />(~JANTITY AIVE~NT <br /> 1 $20.00 <br /> ~7.68 <br /> 1.00 <br /> <br />$28.68 <br /> $0.00 <br />$28.68 <br /> <br />$0.00 <br /> <br />NO: 11806 <br />CHE;K ~: 1614 <br /> <br /> ITrm IE,SUE DATE. IF <br /> FAIL8 TO MEET ALL <br /> ORDINANOE~, THI~ PER'tIT <br />// <br /> <br />fORM # MC I 5-5u REV e/~ OF FICE COPY <br /> <br /> <br />