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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 /> am a registered builder OR the authorized representative <br /> <br /> The work will be performed by a registered builder. <br /> Other <br /> <br /> DA'rE: 08/03/90 TIME: q1:22:08 <br /> <br />'OWNER'. NIEDERI , LYLE <br /> <br /> 100 130 PIRSf S'r -- <br /> DE'r ROi l' OR 9'i"~42 <br /> <br />USE OF BUILDING: <br />MAILING ADDRESS: <br /> <br />SIGNATURE OF APPLICANT: <br /> <br />CATE: <br /> <br />; TAX LOT; <br /> <br />: CoNtRAcT CITY; UGE <br />DETROIT NO <br /> <br />SUBDIVISION; <br /> <br />LO/: BLOCK: <br />WfC~H: DEPTH: <br /> <br />CATEGOI~Y: RESI DENT tAL <br /> <br />OCCUPANT LOAD: <br /> <br />SITE NUfVIB ER: 10823 <br />VALUAT ION: <br /> <br /> ZONE: MAP: <br /> CO~N~O <br /> <br />NO OF <br /> <br />TYPE: ELECTRICAL <br /> <br />CON'fRACI'OR, NO. <br />LICENSE NO: <br />NiEDER'I', LYLE <br /> <br />PERffliT OR APPLICATION NO: 26137 <br /> <br /> SUPERVISING ELEC'I'RICIAN/NUIVlBER <br /> <br />PHONE: 632-6196 <br /> <br />MOBILE H,~(:~I,E $~ACE (SVC EC~UtP) <br />FLEET SURCHAR6E -ZONE ? <br />ELECTRICAL STATE SURCHARGE <br /> <br />QUANT~'T'Y AP~OUN'T' <br /> 1 $25.oo <br /> ~8.9B <br /> <br />'T'OI'ALA,S.S~EO FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />$35_21 <br /> $o.00 <br />$35.21 <br /> <br />BALANCE f3UE $0.00 <br /> <br />PAYEE: NIEDER'f', LYLE RECEIPT NO: 2?690 <br />RECEIVED BY: CL ................................................................................. TYPE: iN CHECK ~: 0 <br /> <br /> ~ TH[~ [~ A VALIO PER~IT * TH[~ PER~[~ EXP[REE~;180 QAY~ FRO~ IT~ I~JE DATE. <br />ODIV~TRUCT[ON CEASES FOR A FA[L~ TO ~EET ALL <br />RE~UIRI!~BNT~ OF STATE LA~AND:I~iARIONO[]UNTY BUILDING AND ZONING ORDINANCES, THIS PEI~4IT <br />~'IALL BEE~fflE NULL ANDVOiD; <br /> <br />RB~IARKS: 1MH SVC <br />EYONALO E. (4COOLEY, MARION r..T,Z.IN'I'Y BUILDING OFFICIAL / BY ............................. ~ .............................................. <br /> <br />OFFICE COPY <br /> <br /> <br />