Laserfiche WebLink
MARION COUNTY BUILDING INSPECTION <br /> SENATOR BLDG, NO, 225 <br /> 220 HIGH STREET NI= <br /> SALEM, OREGON 9.7301 ..:- <br /> <br /> PHONE: 588-5147 8:00- 4:30 <br /> 24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am performing wor~ on a property I own or oooupy. <br />I ~lr~ a registered builder OR the authorized represen a ive <br /> of a registered builder, <br />Fhe work will be performed by a registered builder. <br />Other <br /> <br /> I have read and agree to Ihe terms stated on the reverse Side of <br /> this docupqent <br /> <br /> DATE: 01/09/91 TIME: 14:42:06 <br />OWNER. <br /> B 1ELENBER~. T I M <br /> <br />SIGNATURE OF APPLIOANT: <br /> pATE: <br /> <br />TAX LOT: <br /> 61964~000 <br />CONSTRUCTION TYPE: <br /> <br /> ?925 HILTON LANE <br />'TURNER OR <br /> <br />USE OF BUIL. OING: <br /> <br /> ~ ' ¢ONTRAO}' ~ITY: UGB: <br />97392 <br /> MAD!ON ,COUNTY 1'40 <br /> <br />MAILING APORESS: : SUgOIVISrON; <br /> <br />11314 MILL CK RD <br />AUI~'~VlLLE, ORE 97325 <br />~HONE~ 769-2090 <br /> <br />LOT BLOCK SECTION: TOWNSHIP <br /> <br /> 26 9S <br />WIDTI4 DEPTH. AREA: UN~TS: <br /> 60_ AC <br /> <br />S]TE NUIV~BR: 9138 <br />VALUAT I f,;,:,N: <br />RANGE ZONE: <br /> <br /> 2N EFU <br /> RREG LOT CORNER <br /> NO <br /> <br />RESIDEN']'ZAL <br /> <br />OCCUPANT LOAD: <br /> <br />IYPE: ELECTRJ. CAL PERT,11I' OR APPLICATION NO: 9029609 <br /> <br />C~oN'r P~,C'[OR ~ NO. 459'~3 <br />LI CEN:SE NO: <br />PACIF'iC OO.A~[' ELEC. ,INC. <br /> BOX 651 <br />tS'fAY'ION. OR 97383 <br />F~rONE: '169~76'!1 <br /> <br />3AJPERVlSiNG ELEC'r R,t C IAN/NUMSER <br />LEONARD MYERS <br /> <br /> i 'f'gffl <br />~ERViCE/f':EEOER 101 TO 400 APIPS <br />15LEC]'R1CAL STATE SUR%HAR'GE <br /> <br />OLIAN'I't'I'Y AJvlOUNI <br /> 1 $80.00 <br /> $3,oo <br /> <br /> PREVIOUS RECEZPTS $0.00 <br /> 'I'H~S RECEIPT $36_?5 <br /> <br />FOLLO~1NG I~U~T BE ~PLETED. JT JS THE R~]B~L[TY OF THE APPLI~T TO ~RE THAT <br />ALL N~ INFO~TJ~ H~ <br /> <br />PLAN REVIEW: BY <br /> <br />R~ARKS: 200 A/vip ~ERV <br /> <br />OAI'E Cll'Y JURISDiC'T'iON: BY <br /> <br /> ~5646 W~'FH BAL. DUE <br /> <br />DATE <br /> <br />FORM # MC 15.56 REV, 4/t~0 OF FICE COPY <br /> <br /> <br />