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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 PM - 8::00 A M <br /> <br />I am perform~n0 work on a propedy I Own or occupy <br /> <br />DATE: 03/09/89 TIME: 3:06:58p <br />OWNFR <br /> <br /> ~ANTIA~,I SANITARY SERV/BRENTANA, SAN <br /> <br />lAX LQT CATEGORY <br />56282-000 COMMERCIAL <br /> <br /> 9613 MILL CREEK RD OONTnACTCITY UGB OCCUPANT~A~ <br />AUNSVILLE 9? 325 <br /> AU~4SViLLE NO <br /> <br />PO BOX 189 <br />SUBLIMITY 9?385 <br />PHONE: SITE NUiV~ER: 6?05 <br /> VALdATION; <br /> ~T RtOCK SEQ F~ON TOWNSHIP RANGE ZONE MAP <br /> <br /> 30 3S 1N IND <br /> 188 264 SF YES NO <br /> <br />TYPE: ELECTRICAL <br /> <br />CONTRACTOR, NO. <br />LICENSE NO: <br />SANTIAI~I SANITARY SERV/BRENTANA, <br /> <br />PO 8OX 189 <br />SUBLIMITY 9?385 <br />PHONE: <br /> <br />PEI~4IT OR APPLICATION NO: 9014429 <br /> <br /> SUPERVISING ELECTRICIAN/NUIVIBER <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />]]4IS RECEIPT <br /> <br />QUANTITY AHOUNT <br /> 1 $25.00 <br /> ~3.84 <br /> 1.25 <br /> <br /> ITEM <br />C/I F6EDER TO 100 A~PS <br />FLEET SURCHARGE -ZONE 3 <br />ELECTRICAL STATE ,SURCHARGE <br /> <br />$30.09 <br /> $0.00 <br />$30_09 <br /> <br />BALANCE DUE $0.00 <br /> <br />PAYEE; SANTiA]¥1 SANITARY SERV/BRENTANA, SAI'4 RECEIPT NO: 15303 <br />RECEIVED BY: Df4 TYPE: IN CHECK ~: 0 <br /> <br />* THIS IS NOT A PER~4IT. THIS APPLICATION MUST GO THROUE~ A REVIEW PROCESS WHERE THE <br />FOLLOWING rYtJST BE COMPLETED. IT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT <br />ALL NECESSARY INFO~!ATION HAS BEEN PROVIDED+ <br /> <br />PLAN RE'CIE]N: BY <br /> <br />REHARKS: 100 AMP FEEDER <br /> <br />DATE .... CITY JURISDICTION: BY ........ DATE .......... <br /> <br />~ORM ¢¢ MC I~ 5(, RFV H'88 OFFICE COPY <br /> <br /> <br />