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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: 588-5t47 8:00 - 4::30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> i am;~ registered builder OR ( )th(} authorized representatwe <br /> o a eg s e ed builder. <br /> 'The work will be performed by 8 registered builder. <br /> Other <br /> <br />DATE: 12/05/91 'I' .[/~lE: 9:38:17 <br /> <br /> KNOX, MICHAEL G & LiNDA L <br /> <br />ifA~ LbT: <br /> <br /> 6691 PE'rgRs ROAD SE .... UGS: <br />AUl~Vl LLE OR 9'I.325 <br /> <br />MAILING ADDRESS; ':' SU EDIVi~i~N: <br /> <br />10965 JAIViEL,$ WAY DRIVE <br />AUI"a~V/LLE 97325 <br />PHONE: 749-2155 <br /> <br />~E <br /> <br />iiOT: ~Loc kl isEcfio N: <br />WIDTH: !bEPTR; : AREA: <br /> <br /> SiTE NUNBER *. 9586 <br /> VALUAT tON: <br /> iTOW~S~IP: : RANGE: I ZONE: <br />19 8S 1W AR <br /> i UNITS: IRREG. LOT; CORNER; <br /> 7. Ac YEE)I NO <br /> <br />RES[ OENT iA~ <br /> <br />TYPE: EL[~CTRICAL <br /> <br />CToNrRAC'FOR, NO. <br />LICENSE NO: <br />KNOX, MiG~AEL G & LINDA L <br />10965 JA~IES NAY DRIVE SE <br />AUI~V1LLE 97325 <br />PHONE: 749-2155 <br /> <br />PER/ViIT OR APPLiCATZON NO: 32584 <br /> <br /> ~PERVI$iNG EL~C'rRiCiAN/NUrfl~ER <br /> <br /> iTE.~ <br />BRANCH CIRCUITS - ONE <br />ELECTRICAL STATE SURCHARGE <br /> <br />C~JANTi'fY AFYOUN1 <br /> 1 $35,00 <br /> $1.75 <br /> <br />'rOTALA,.%,~ED FEE,~ <br /> PREVIOUS RECEIPTS <br /> 'FHIS RECEIPT <br /> <br />$36.75 <br /> <br /> $o.o0 <br /> <br />BALANCE DUE $0.00 <br /> <br />PAYEE: RECEIPT NO: <br /> TYPEt CHECK <br /> <br /> 0 <br /> RECEIVED BY= gL ............................... ;. ............................... <br /> <br />* THIS ls A VALID PEI~41:T *THZS:.:PEt~'4[T .ExPiRES180DAY5 FROI~ ITS iSSUE DATE. iF <br />CONSTRUCTION CEASES FORA PERiODOF 180DAY~,OR [FCONSTRUCTiON FAILS TO I~IEET ALL <br />f;~XJiRE~IENT~ OF STATE LA~SANGI~ARION C~UNTYBUILDiNG~ANO ZONING ORDIN.N~CE~, THIS PER,liT <br />~HALL BE~0~IE NULL AND VOID. <br /> <br />REIViARKS: 1 ClR FOR HELl.. <br /> <br />[Y, gNALD E. NOODLEY, I~,lARION COUNTY BUiLDiNG OFF'ICIAL /BY ................................................................................................ <br /> <br />OFFICE COPY <br /> <br /> <br />