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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO. 225 <br />290 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONE 4:;30 P.M. - 8:00 A.M, <br /> <br />The work will be performed by a registered builder. <br />Other_ <br /> <br /> I have read and agree to the ternhs stated on the reverse side of <br /> this document. <br /> <br />DATE: 08/31/87 TIME; <br />OWNER: <br /> BRYANT, RONALD W. <br />SITUS ADDRESS: <br /> <br />} 'FAX LOll .... iCAfE~0.Y: <br />, C0N~¥F~(~8~,O~ +'TP6 i OCCU.ANCY: <br /> <br /> 14812 SOB'S AVE i'c~)74~'~,E~"~if,~i UGB: !OBCUF~AN¥ LoAg; <br />.AURORA OR 9?002 , ~ <br /> <br />MAILING ADDRESS: <br /> <br />SAME <br />PHONE; 678-1065 <br />LO'(: ;BLOCK: <br />WIDTH: IDE PTH'. <br /> <br /> I SITE NUMBER: 2363 <br /> ' VALUATION: <br />:SE¢'hON; ! '~(~W~'S'~ {'tg:' , i RANeE; !ZONE: <br /> <br /> NO <br /> NO <br /> <br />MAP; <br /> <br />TYPE ~ ELEC-FRICAL <br /> <br />CONTRACTOR, NO. <br />LICENSE NO: <br />BRYANT, RONALD N. <br />SAME <br /> <br />PHONE: 678-1065 <br /> <br />PERMIT OR APPLICATION NO: 4058 <br /> <br /> ,SUPERVISING ELECTRICIAN/NUMBER <br /> <br /> iTEM <br />SERV CHANGE ONLY-EXISTING RESIDENCE <br />T~O OR MORE NE~ C~RCUITS;ALT OR EX'T <br />FLEET SURCHARGE --ZONE 8 <br />ELECTRICAL STATE SURCHARGE <br /> <br />PAYEE; BRYANT, RONALD ~. <br /> <br />TOTAL ASSE~ED..FEES <br />. ,~RBVIOUS .RECEIPTS <br />"'TH.~S. RECEIPT <br /> <br /> BALANCE ~UE <br /> <br />QUANTITY A~OUNT <br /> 1 <br /> $20_00 <br /> $?.68 <br /> '32.00 <br /> <br />$49.68 <br /> <br />$0_00 <br /> <br />RECEIPT NO: 4620 <br /> <br />RECEIVED 3Y; ¢8 ................... ~PE. EL CHECK ~. 4588 <br /> <br />~ 'PHIS IS A VALID PER~4IT * ll-II~ PEI:~4IT, ED(PI'RED~ I$O':DA~ FRGN,ITS IEx.qUE DATE. IF <br />CONSTRUCTION CEASES FOR A PERIOD'~F.~,I~0 DAYS. OR .IF CONSTRUCTION FAILE, TO MEET ALL <br />RF_.QUIRENENTS OF STATE [.AN5 AND RARION :COUNTY BUILDING'AND ZONING ORBIt, THIS ~IT <br />SHALL BECOME NULL ANO VOID. <br /> <br />REMARKS: SERV.CHG./2 CIR. <br /> <br />DONALD E- NGODLEY, MARION COUNT~ BUILDING OFFICIAU / BY <br /> <br />OFFICE COPY <br /> <br /> <br />