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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 Cfi ~ Oroperty I own or occupy. <br /> l am a registered builder OR ( )lheauthorized representative <br /> of a 'eL s Bred b d]de <br /> The work Wilt be performed by a registered builder. <br /> <br />DATE: 01/29/92 TIfAE: 12:.38~20 <br /> <br /> R~ ES'f'ERER, BERNARO <br /> <br />56361-8/5 <br /> <br />CATEGORY: <br /> <br />OCCUPANCY: <br /> <br /> 8521 HOLt4~lS'r RD <br />AU~3Vl LLE OR 9?325 <br /> <br />CONTRACT CJTY; UGh: <br />?~AR i ~4 COUNTY NO <br /> <br />OCCUPANT LOAC: <br /> <br />MAILING ADDRESS: <br /> <br />P.O BOX 255 <br />SUBLIMi1'Y, OR 9?385 <br />PHONE: 585-7420 <br /> <br />SUBDIVISION: <br /> <br />P'LOODPL.AIN <br /> <br /> SiTE NUMBER: 92-00223 <br /> VALUATION: <br /> TOWNSHIP: RANGE: ZONE: <br />31 85 1N AR <br />2.86 AC NO NO <br /> <br />RESIDbN~iAL <br /> <br />MAP: <br /> <br />TYPE= ELECTRICAL <br /> <br />CON'rlg:Ac'FoR, NO. 79147 <br />LiCEN3E NO: <br />ffIACK DRiLLiNG MACK DRILLING <br />708 J DAVID ST <br />SE SAL~,I, 9?$06-0000 <br />PHONE: 371~4399 <br /> <br />PERMIT OR APPLICATION NO: 37954 <br /> <br /> SUPERVISING ELEC'fRiCiAN/NUMBER <br /> <br /> I'rE~ <br />PUMP OR iRRiGA'F]ON CIRCLE <br />EL~C'I'RICAL STATE SURCHARGE <br /> <br />QUANTITY AI',IOUN] <br /> $3~_00 <br /> <br />'I'O'rAL 4Z"""""""""""""""""$5~¢D FEES <br />PRE¥iOUS R~EIP"rs <br />THIS RECEIPT <br /> <br />$3?.80 <br />$37,80 <br /> $o.oo <br /> <br />BALANCE DUE $0.00 <br /> <br />PAYEE; RECEIPT NO: <br />RECEIVED BY: DM 'tYPE: CHECK ~; 0 <br /> <br />* THIS IS A VALID PERi, iT ~ THIS PE~4iT EXPIRE~ 180 DAYS FRO¢4 ITS IL>SUE DATE. IF <br />CONSTRUCTION CEA~~'~ FOR A PERIOD OF 180 DAY~, OR IF CONSTRUCTION FALLS TO MEET ALL <br />~E-QULIREI~ENTS OF STATE t_NN~ N~ID ~RIONCOUNTY BUILDING AND ZONING ORDiN~NCt~S. THiS <br />L BE~3~IE NULL ~D VOID. <br /> <br />REf,~RKS: PU~P <br /> <br />D©NALD E. 14000LEY, MARION COUNTY BUILDING OFFICIAL / BY <br /> <br /> OFFICE COPY <br />FORM # MC 1 ~-56 REV. 4/90 <br /> <br /> <br />