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SENATOR BLDG. NO. 225 <br /> 220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PH(~NE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />Other <br /> <br />SIGNA'fURE OF APPLICANT: <br /> <br /> DATE: <br /> <br />07/27/90 TIME: 8:20:36 <br /> <br />SITUS AO~REs~IELENBERG, TIM <br /> <br />i CONSTRUCTION TYPE: (51964'000 <br /> <br />7925 HILTON LANE SE <br /> <br />MARlON COUNI'Y <br /> <br /> CATEGORY: <br /> <br /> OCCUPANCY: RESi DENTLAL <br /> <br />OCCUPANT LOA~: <br /> <br />MAILING ADDRESS: <br /> <br />SUBDIVISION; <br /> <br /> 11314 MILL OK RD <br /> AUf,tBVJLLE, ORE <br /> PHONE= ?69-2090 <br />LOT: <br /> <br /> SiTE NUttiER: 9138 <br />SECTION; ,TOWN~HIP: R~[_U~Ti~: ZONE: <br /> <br />MAP: <br /> <br />DEPTH: <br /> <br />: AREA: 26 : UNITS: 9$ ; IRREG. LOT: 2~ CORNER: EP~J <br /> <br /> 80 Z : ,AC NO <br /> <br />TYPE: ELECTRICAL PERMIT OR APPLICATION NO: 22490 <br /> <br />CONTRACTOR, NO. 45933 <br />LicENSE NO: <br />PACIFIC f..%)A~'r ELEC.,iNC. <br />P.O. 80X 651 <br />STAY'tON, OR 97383 <br />PHONE: 769-7671 <br /> <br />SUPERVISING ELECTRiCiAN/NUNBER <br />LEONARDMYERS <br /> <br />~OBILE HO~E SPACE (~VC EQUIP) <br />~OBILE HOME CONNEC'f'[ON <br />FLEET SURCHARGE -ZONE 2 <br />ELECTRICAL STATE SURC,I,,tAI~,E <br /> <br />QU~'~I'II'Y A~,C)UN'I' <br />1 $25.00 <br />1 $25.00 <br /> <br />PAYEE: PACIFIC COAST ELEC.,INC. <br /> <br />TOTAL A~ED FEES <br />PREVIOUS RECEIPTS <br />THiS RECEIPT <br /> <br />55.96 <br /> <br />BALANCE SUE $0.00 <br /> <br />RECEIPT NO: 2?488 <br /> <br /> RECEIVED BY: PB TYPE*. CK CHECK ;~: 4478 <br /> <br /> THIS IS A VALID P~I~IIT * l~-118 PER~IT ~Pi~ 180 ~ F~ ITS I~E ~TE+ IF <br />~ST~CTI~ ~ ~R A ~Ri~ ~ 180 ~, OR IF ~ST~CTI~ FAZ~ TO ~ET ~L <br />~I~TS Nu~T~ ~.~0 ~R[~ ~NTY ~I~i~ ~g Z~JN6 ~DJN~C~, THIS ~JT <br />~ALL B~E <br /> <br />RECGARKS: NH SERV/ & CON RI¢2272 <br /> <br />DONALD E. ~OODLEY, MARION COUNTY BUiLDiNG OFFICIAL / BY <br /> <br />OFFICE COPY <br /> <br /> <br />