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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 $88-5147 <br />CODE-A-PHONE 4:90 PM, - 8:00 A,M. <br /> <br />The work will be performed by a registered builder, <br /> <br />D~,TE: 39/13/S9 TINE: 10:35:13a <br /> <br /> JORR;TSMA & ZACHER <br /> <br />SIGNATURE DP APPLICANT: <br /> <br /> BATE; ........ <br /> <br />TAX LOT: <br /> <br />SITUS ADDRESS: <br /> <br /> !2377 DONALD RD NE <br /> <~,LIRO~A OR 97.0.02 <br /> <br />USE OF BUILDING: <br /> <br />CONSTRUCTION TYPE: <br />NIAR T ON COUNTY NO <br /> <br />MAILING ADGRESSI <br /> <br />CATEGORY: <br /> <br />OCCUPANCY: <br /> <br />OCCUPANT LOAD: <br /> <br /> NO OF BEDROOMS: <br /> <br /> ?HONE · <br /> <br />LOT: BLOCK: SECTION; TECWNSHI¢: <br /> <br /> SITE NLIMBER; 301~ <br /> VALUATION: <br /> <br /> RANGE: ZONE: <br />4S %4 EFU <br /> NO NO <br /> <br />MAP: <br /> <br />Ty.c'E: ELECTRICAL PERf~IT OR APPL:CAT!ON NO: <br /> <br />CONTRAC'F'OR, NO. 59829 <br />L[CENSE Ix!,;'): <br />..rR ELECTRIC <br />PO BOX 265 <br /> ~.,~,,a,~ u,-,EGOH 9?032 <br />PMON E; ~ 8 ~ --39 ! 3 <br /> <br />SUPERVISING ELECTR:C IAN/NUMBER <br />JOSEPH V_ DRYDEN : 3!38S <br /> <br />FLEET SURCHARGE '-ZONE <br />EL. ECTR~CAL ST$~E SURCHARGE <br /> <br />$7 8,.° <br /> <br />~OTAL',ASSESSED, FEES <br />PREVIOUS RECE:PTS <br />THIS RECEIPT <br /> <br />BALANCE <br /> <br /> THIS .S A VALID PER~IT ;~ ::,~,,~B,I,S_,,,,~ERt4;[T EXP;[RESi~8,g(;:~A.,,~. ~,,,E~M/,:[TS ISSUE DATE. IF <br />~ST~CTION CEASES FOR A:~ ~I~D?:~,,~F ~E,~,',~S~CTZ~ FALLS TO ME~ ALL <br />REdIReCTS OF STATE ~ ORDIN~CES. THIS PE~IT <br />~ALL BEdE NULL ~D VOiD '~? "' '~: <br /> <br />~,~ ~ ~ (( v ~ ~ ' <'l T '~T ~'~ C T r~ ~v _~ __~_~~ ..................... <br /> <br />FO"M ~' MC 15.~6 R~V 11/88 OFFICE COPY <br /> <br /> <br />