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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 22,5 <br />220 HIGH STREET NE <br /> SALEM1 OREGON~ 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />Other <br /> <br />SIGNATURE OF APPLICANT: <br /> {)ATE: <br /> <br />OWN~I'E: 07/24/91 'flNIE: t1-:20:44 <br /> <br /> LUCAS, ROL~ EY <br /> <br />TAX LOT: CATEGORY: <br />~ON~RUbTIO~ tYPE: i OCCUPANCY <br /> <br />RESLDEN'1'LAL <br /> <br /> 6?92 Ni'rZEL ROAD SE }CONTRACT CITY; ! tJ~B: 10CCUPANT LOAD: <br /> TURNER OR 9?392 ~ <br />USE OF BUILDING: ~R}~ O~MNTY.J N~ :.o o; ~EDA00US <br /> <br />MAIL,lNG ADDRESS: ~ ~ ~BDIVISION: <br /> <br />5771 LIBERTY RD S <br />5~ALEIVl, OR 9?305 <br />PHONE; 364-0528 <br /> <br /> SITE NUMBER; 9066 <br /> VALUA'F tON; <br />LOT: BLOCK: BECTiON: 'TOWNSHIP: RANGE; ' ZONE; MAP: <br /> <br /> ~1 85. : SA <br /> : AREA: UNITS: IRREG. LOTI ~ CORNERI <br /> <br /> 1.9 [ AG', , NO NO <br /> <br />WIDTH: <br /> <br />TYPE: ELECTRICAL <br /> <br />CONTRACTOR. NO. <br />LICENSE NOr <br />LUCA$, <br />5771 LIBERTY RD ~ <br />SALEM, OR 97305 <br />PHONEt 364-0528 <br /> <br />PERC41T OR APPLICATION NOs 33666 <br /> <br /> ~:itJPERVlSiNG ELEC'FRiCIAN/NUCVlBER <br /> <br />MANUFACTURED HO¢4E SERViCE/FEEDER <br />ELECTRICAL SI'ATE SURC'HAR~E <br /> <br />PAYEE: <br />RECEIVED <br /> <br />(~JANTITY AI~N'I' <br /> 2 $70.00 <br /> $3.5o <br /> <br />'I'OTAL~E?~SEDEEE,~,$ <br />PRE¥ir.x,J$ RECEIPTS <br />THIS RECEIPT <br /> <br />~73.50 <br /> ?3.50 <br /> $o.oo <br /> <br />BALANCE DUE $0.00 <br /> <br /> RECEIPT NO: <br /> ]'YPE~ CHECK <br />.................%=,'f",'"~ (t(!,ft':,'~t ~ !~,~! ~ % ~ ....................... ~ ....................... <br /> <br /> * THI~ IS A VALID PERMIT * THIS PER,liT EXPIRE~ 180 DAY~ FR~4 ITS I,~UE DATE. IF <br />CONSTI~JCTION CEA~I~5 FOR A PERIOD OE180 DAYS, OR IF CONSTRUCTION FALLS TO NEET ALL <br />~EQUIP~TS OF STATE LA~AND~IARION COUNTY SUILDINGAND ZONING ORDINANCES, THIS P~RMIT <br /> ALL BECOME NULL AND VOiD. <br /> <br />REMARKS: 1'4H SVC & CON F~6627 <br /> <br />DONALD E. NOODLEY. 1'4ARION r__.OJNTY BUiLDiNG OFFICIAL / BY <br /> <br />FOR~I # BO l~-~ REV, 4/~ OF FICE COPY <br /> <br /> <br />