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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 performing WOrk Or~ aproperty I own Or ocodpy, <br />I am a reqis~ered builder OR the authorized representative <br /> <br />have read and agree to the terms stated on the reverse side of <br />H)is document. <br /> <br />SIGNATURE O¢ APPLICANT: <br /> DATE; <br /> <br />ow~TE: 05/14/'91 'I'JI~1E: 15=15:38 <br /> CF.]'4 I"Z LER, <br /> <br />CONSTRUCTION TYPE: <br /> <br /> 10523 POR'rER RD <br /> AUf4SVjLLE OR 97325 <br /> <br />USE OF BUILDING: <br /> <br />SE <br /> <br />i ~ONTRACT CITY: UGB: <br />hlARiCN COUNTY i NO <br /> <br />MAILING ADDRESS: <br /> <br />10663 PORTER RD 8E <br />AUI~VILLE <br />PHONE: 749-2640 <br /> <br />LOI: BLOCK: ' SECTION: <br /> <br />DEPTH: AREA: <br /> <br /> SITE NUf4BER; 10593 <br /> VALUAT <br /> ! TOWNSMiP: RANGE: <br /> <br />6 9S 2W EF'U <br /> UNWB: i IRREG. LOT: CORNER; <br />66 AC : NO ; NO <br /> <br />CATEGORY: <br /> RES ~, DEN T i AL <br />OCCBRANCY; <br /> <br />TYPE: ELEC'I'RiCAL <br /> <br />CON'rRAC'FOR. NO. <br />LICF...NaE NO: <br />6EN'FZLER, gY3N <br />10663 POR'rER RD SE <br />AMI~I~.VILLE <br />PHONEt ?49-2540 <br /> <br />PERt411' OR APPLICATION NO: 31831 <br /> <br /> ,~UPERVISING ELE%'I'R[CIAN/NUr, ABER <br /> <br /> ITFJ~I <br />8PCClCH Olk%~i'r$ - 'FNO TO TEN <br />ELEC'fRZCAL S'I'AI'E SURCHAf'~3E <br /> <br />PAYEE: <br /> <br /> 'rOTAL~E~EDEE~,~ <br /> PREVIOUS:RECEiPTS <br /> 'rHiSiRECEZPT <br />BALANCE <br /> <br />t~JAN'f'II'Y ~&IC~JN'I <br /> 1 $50~00 <br /> $2.5o <br /> <br />RECEIPT NO: <br /> <br />$52.5O <br />$52.50 <br /> $0.00 <br /> <br />$0.00 <br /> <br /> RP. SC£iV£D BY: P'B TYPE: CHECK ,11:: 0 <br /> <br /> * TflJ[~ i$ A VALID PEr, lIT PER~iT EXPIRE~ 188 [~¢~ FR~ ITS IG....~JE lC)ATE, iF <br />OON~TRUCTION CEA~F~ FOR A PEI~IOD OF 180 BAY~; OR 11= CONSTRUCTION FAIL...~ TO r,IEET ALL <br />~J[REt4ENTS OF STATE LAIA~ ~e~lO IW~ARj[ON COUNTY BUILDJ[N~ ~N~ID ZONING OROZN/iC~CE~, THI~ PER~II?' <br />LL BEODI~E NULL AND VOID. <br /> <br />REt, tARKS: 2- 10 CIR RI,3577 <br /> <br />DONALD E. Ic¢3ODLEY. ~RiONC,'(~JNTY BUILDING OFFICIAL / BY <br /> <br />OFFICE COPY <br /> <br /> <br />