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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 /> Other . <br /> <br />L~A'f'E: 07/10/90 TIME: 15:21:15 <br /> ALLEN, CLAY <br /> <br /> 7~00 SKYLINE RO <br />SALEM OR 97306 <br /> <br />SIGNATURE OF APPL~CANT:~,,~, <br /> DATE: <br /> <br /> TAX LOT: <br /> <br />; CONSTRUCTION TYPE: <br /> <br />71660-080 <br /> <br />! d~h~fRSOT CITY; ~ <br />~1ARiON f.,T.~NTY ' NO <br /> <br /> 1724 22N0 ST SE <br /> SALEM, OR 97392 <br /> PHONE: 378-1416 <br /> <br />LOT: :BLOCK: <br />10 <br /> <br />SUBDIVISION; <br /> <br />; SEbTION: TO~VNS~Ip; <br /> <br /> 3O 8S <br /> <br /> 9.7'8 AC <br /> <br />CATEGORY: <br /> RES i DEN 1 ,[ AL <br /> <br />OCCUPANCY: <br /> <br />OCCUPANT LOAD: <br /> <br />ORAl6 Fat)il' FAf,~ <br /> <br />SITE NUIVlBER: 9564 <br />VALUAT ION: <br /> <br />RANGE: ZONE: <br />SA <br /> <br />MAP: <br /> <br />TYPE: ELECTRICAL PERt4i'r OR APPLICATtCN NO= <br /> <br />25471 <br /> <br />CONTRACTOR, NO. 65444 <br />LICENSE NOt <br />CONNEC'flONS ELECTRIC iNC. <br />P.O. BOX 7136 <br />SALE?4, OR 97303 <br />PHONE: 390-7914 <br /> <br />SUPERVISiNS ELECTRICJAN/NUI~ER <br />3573-S <br /> <br /> iTE~ <br />R~NIRiNG 2000 ~ F'r OR I~X~RE <br />FLEE]' SURf..AHARGE -ZONE 2 <br />ELECTRICAL STATE SURCHARGE <br /> <br />QUANI'iI'Y <br /> 1 $105.00 <br /> <br /> 5.25 <br /> <br /> TOTAL ASS~ED FEE~ $1 ] 2- 81 <br /> PREVIOUS RECEIPT8 $0.00 <br /> THIS RECEIPT $112.81 <br /> <br /> BALANCE OUE $0.00 <br /> PAYEE: CONNECTIONS ELE~CTRIC iNC. RECEtP't- NOt 26980 <br /> RECEIVEO BY: PR TYPE: CK CHECK ~;: 1099 <br /> * THIS iS A VALIO ~IT * THIS i:~RNIT EXPIRE~ 180 DAY5 FRObl ITal iS,..~JE OATE. IF <br />CONSTRUCTION CF--A.SE~ FOR A PERIOD OF 180 DAY]S, OR IF C0NfATRUCTION FALLS TO fflEEf ALL <br />~HRE~..Ii~TS OF STATE ~ AND i~tRION COJNTY BLIILOINEi A~ID ZONING ORDINANCES, THIS PER~lIT <br /> ALL BIBC~I~E NULL AND VOID. <br /> <br /> REd'lARKS: RES N i RING >2000 F'r R~2598 B~~~ <br /> <br /> OFFICE COPY <br />FORM//MC 15-56 REV. <br /> <br /> <br />