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MARION COUNT~. BUik4~ING INSPECTION
<br />SENATOR BLIJ-G, NO, 225
<br />220 HIGH STREET NE
<br /> SALEM, OREGON 97301
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<br /> PHONE $88-$147
<br />COD~:-A-PHONE 4:30 RM. - 8:00 A,M.
<br />
<br />~ am performing work on a property I own or occupy.
<br />
<br />of a registered builder.
<br />
<br />I have read and agree to the terms ~tated On the reverse side Of
<br />this document,
<br />
<br />SIGNATURE OF APPLICANT:
<br />
<br /> DATE'.
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<br />ow~hTE: 09/12/89 TIME:
<br />
<br /> H[VEL. EY, DELS[a.?E
<br />SITUS ADDRESS:
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<br /> 'i4070 .,,E,=o 14
<br />lO, Ur;fORA OR 97002
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<br />CONTRACT CITY; UGS; OCCURANT LOAD
<br />,'¥.~,RION COUNTY NO ~ NO O~ S~,I)ROOMS:
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<br />MAILIN~ ADDRESS: ....
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<br />~ue6ivi~i6~i
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<br /> PO BOX 565
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<br /> PHONE: 5,_02..-5855
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<br />LOT: BLOCK:
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<br />SECTION: TOWNSHIP
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<br /> :'SL!N!:'}ETM PiO8 ~ L_E ~ARK
<br />
<br />,, I~ ,,~ ,,, 4,980
<br /> ,% Li,,Yr j ©N ..
<br />
<br />WIDTH: 5 DEPTH: ~ AREA: 0~ UNITS: 4 '¢;; IRR6G hOT' q~"! COHNEH; ,/~',~
<br /> '?0 ', g0 ?0O0. gO S? :,,iO ;%')
<br />
<br />3
<br />
<br />.... ,<:'E ........... ~ "¢~" ' R I,~,A"' ,~:~,,,~ T ~. r~,,, OR APPL [CATION NO' ''* ~c,.,
<br />
<br />,'3ONTRACTOR, NC). 20919
<br />L.IC~NS~
<br />DEAR ELECTR],C, TNC.. '
<br />c,o SOx 389 20985 SUTTEV!ULE RD
<br />OONALD, OREGON 97020
<br />?HONF: $?8'-'~358
<br />
<br />SUPERV;ST. NG EL..ECTRTC L~N/r<..r'4SER
<br />
<br /> TOTAL ,ooESS~; ~:SES
<br /> PREV_TOUS RECE Y-YT'S
<br />
<br />BALANCE DUE
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<br />AHOUNT
<br /> $25.o0
<br /> $25..88
<br />
<br /> 2.50
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<br />$ 5 0- ',
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<br />~AYEE: SEAR EL~;CqR;C,' ]'NC RECE]?-'IT ~: ~ l 19959
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<br />* THIS IS A VALID PERMIT :~ i0:{~$,:,:PERtfl[T EXPIRES 180 DAYS FROM ITS ISSUE DATE. ZF
<br />CONSTRUCTION CEA,SE~ FOR A,;PERIODjOFI@0 DAYS, OR IF CONSTRUCTION FAILS TO HEET ALL
<br />REq~JIREMENTS OF STATE LAMS ~B3:~RION COUNTY BDILBING .aND ZONING ORBINANCES, THIS PERt4IT
<br />S,HALL BECONE NULL ,aND VO[,D., ':i,';:: :=
<br />
<br />.......
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<br />SERV & CONN R:PH!28~
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<br /> WOODLEY, M,ARR3N COUNTY SUI~LO{Hlg 2=FiCElalL. / 8TM
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<br />FORM ~' MC 15-56 REV. I:/88 OFFICE COPY
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