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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 <br />CODE-A-PHONE 4:30 P.M, - 8;00 A.M. <br /> <br /> I 8m performing work on a property I own or occupy. <br /> [ am a ruTistof'ed builder OR ) the authorized repre~entatiYe <br /> of a epis ered builde <br /> The work will be porformed by a repistered builder. <br /> Other <br /> I I~ave read and aTfoe to the terms statod on the reverse side <br /> this docur'~ent. <br /> <br /> DATE; 06/07/88 TIME; <br />OWNER; <br /> CHApINESKE, IN_J. & GERTRUDE <br /> <br />TAX LO¥. ' CATE~ORYI <br />CON$TRUCTION TYPE: OCCU PANc~; <br /> <br />RESIDENTIAL.. <br /> <br /> 9684 SILVER FALLS HWY <br />AUMSVILLE OR 97325 <br /> <br />MArL. LNG ADDRESS: <br /> <br /> SANE <br /> <br />PHONE: SITE NUMBER: 4605 <br /> VALUAT I ON: <br />LOT: BLOCK: S~CTION: ~0WNsHiP: RANGE: ~ONE: <br /> ]8 8S IN AR3 <br /> NO NO <br /> <br />MAP: <br /> <br />TYPE: ELECTRICAL PERMIT OR APPLICATION NO: 9008953 <br /> <br />CONTRACTOR, NO. 38238 <br />LICENSE NO: <br />S~N'4TI~4 VALLEY HOMES <br />11373 ~ILLCREEK RD SE <br />AUMSVILLE OR 9?325 <br />PHONE: <br /> <br />SUPERVISING ELECTRICIAN/NUMBER <br /> <br /> ITEH <br />HCSILE HOME CONNECTION <br />FLEET SURCHARGE -ZONE 3 <br />ELECTRICAL STATE SURCHARGE <br /> <br />QUANTITY AMOUNT <br /> 1 $20.00 <br /> $a,84 <br /> $1.00 <br /> <br /> TOTAL:ASSESSEDEEES $24_84 <br /> PREVIOUSRECEiPTS $0.00 <br /> THIS RECEIPT $24,84 <br /> <br /> BALANCE DUE $0.00 <br /> PAYEE: SANTIAM VALLEY HONES ~ ~.~? RECEIPT NO, a~PP <br /> RECEIVED BY: J8 .......... ~. -~¢'c~- TypE: ¢~_ CHECK =; ~l <br />...................................... ~ _~___~--~_, ..~_,.. ~ ......................... <br /> <br />PLAN REVIEW: BY ..... DATE CITYJuRISDI:C~ION: BY ......... BATE <br />REMARKS: MH CONN R~8359 <br /> <br />OFFICE COPY <br /> <br /> <br />