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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 8:00-4:80 <br /> 24 HOUR OODE-A-PHONEi 888~7904 <br /> <br />lamaregistered' builder OR( ) the authorized representative <br />Other <br /> <br />oWNL4~'f g; 10/18/91 ...... I 't'r, lt: t <br /> <br /> GiB~N, OLE]fA <br /> <br /> 3O? CHURCH <br /> AUC4~V,[ LLE <br />USE OF SUILDING: <br /> <br />OR 9?325 <br /> <br />'FAX ~.OT: <br /> <br /> .90080'~200 .......................... RE'~ iDF~N'I' I AL <br />CONSTRUCTION TYPE OCCUPANCY'. <br /> <br />SUBDIVISION; <br /> <br /> PO BOX 855 <br /> AUt4SV 1LLg 9?325 <br /> PHONE: 749-1464 <br /> <br />LOT'. ~LOCK: SECTION: TOWNSHIP: <br /> <br />...... 5 4- T'~,REA 25 <br />WIDTH: DEPTH UNITS <br /> <br /> 1.00[ ....... 1..08 1.0800 ...... <br /> <br />3II'E NUf'4B ER: 5666 <br />nA~¥ALUAT IDL'~ =!; Z~i~[' ..... ~ ............ <br /> <br />TYRE: ELECTRICAL PEf.~li1 OR APPLICATiON NO: 9036204 <br /> <br />CONT~CI'OR, NO. <br />LICF..~SE NO: <br />GIBE, ON, OL£TTA <br />PO BOX 855 <br />AUMSVILLE 97325 <br />fmHONE: 749-1454 <br /> <br />fSUPERVISING ELEC'I'RiCIAN/NUf~3ER <br /> <br /> ITEM <br />BRANON CIRCUITS - <br />ELECTRICAL STATE 8URCHAF~g <br /> <br />F..X.IANTiI'Y AMOUNT <br /> 1 $35.00 <br /> $1.75 <br /> <br />TO'f'AL ~SSED FEES <br />PREVIOUS RECEIPTS <br />THI~ RECEIP'F <br /> <br /> $0.00 <br />$36.75 <br /> <br />BALANCE DU~ $0.00 <br /> <br /> PA~EEz GIBSON. OLE'f'TA Az( NECEIP'f NO:. 38132 <br /> RECEIVED BY- P8 ~,_=~ r'YPE: iN CHECK ~:' o <br /> <br /> THiS IS NOT A PERMIT. THI~ APPLICATION r,,IlJST <br />I=OLLONING MU~T ~E COI~PL~TED. IT I~ THE ~ii~N°~N,~tBILITY OF THE APPLI~JNNT TO A.~mURE THAT <br />,~I=L N~CFJS~>ARY iNFOI~IATION liA,~BF-EN <br /> <br />PLAN RE¥i~: BY <br /> <br />REf4ARKS.* 1 CfR <br /> <br />CITY JURiSDiCTiON: BY OATE <br /> <br />OFFICE COPY <br /> <br /> <br />