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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG..JqO. 225 <br />228 HIGI~S-TREET 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 peffotrfling work Orl a property I own or Occupy. <br />I am e registered builder OR ( ) the authorized representative <br />of a registered builder <br />"the work will be performed by a regbtered buJJder. <br />Other <br /> <br /> I have read and agree to the to(ms stated on the reverse side of <br /> this doouff~ent. <br /> <br /> DATE= 07/26/89 TIME; 1:51;33p <br />OWNER' <br /> 0ORAN, TOM <br /> <br />9008]-271 <br /> <br />CATEGORY: <br /> REoIOEN ~ [Ak, <br />OCCU?ANCY: <br /> <br /> 915 HAZEL ST <br />ALJ~:~VI LLE OR 9?325 <br /> <br />USE OF BUILDING <br /> <br />AUMSVI LLE NO <br /> <br />PO BOX 185 <br />SUBLIMITY OR 97385 <br />~tONEr ?69-7384 <br /> <br />1 ~. 24 <br /> 77 97 <br /> <br />SUBDIVISION. <br /> <br /> GI LOON II <br /> <br /> SITE NUMBER: 7845 <br /> VALUATION: <br /> RANG~: ZONE: MAP: <br /> <br />8S 2W RI 51 <br /> IRREG. ~T' CORNER: <br /> <br />SF YES NO <br /> <br />TYPE: ELECTRICAL <br /> <br />CONTRACTOR, NO, 2075 <br />LICENSE NO: <br />NORTHSIDE ELECTRIC INC <br />PO BOX 7'124 <br />SALEM, OREGON 97303 <br />PHONE: 393.-'5559 <br /> <br />PERJ~IT OR APPLICATION NOt 17683 <br /> <br /> SUPERVISING ELECTRICIAN/NUMBER <br /> ARLIN E. AD~ /1499S <br /> <br /> ~'TEM <br />RES WIRIN~ < 2000 SQ FT <br />FLEET SURCHARGE -ZONE 3 <br />ELECTRICAL STATE SURCHARGE <br /> <br />PAYEE: NORTHSIDE ELECTRIC. ING <br /> <br />QUANTITY AMOUNT <br /> 1 $75-00 <br /> 3.84 <br /> 3.75 <br /> <br />TOTAL"A,~%~'JSED FEE~% <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />$82.59 <br /> $o.oo <br />$82.59 <br /> <br />BALANCE DUE $0.00 <br /> <br />RECEIPT NO; 18781 <br /> <br />RECEIVgD BY: OM T,Y,~,E*.' CK CHECK ~; 7502 <br /> <br />* THIS IS A VALID PERMIT ¢,, h.,~[S'~PERNI'T E)~PI'RE,.S ~'188'.DAYS"F,I:{'0M .,ITS IS.SUE DATE. IF <br />CONSTRUCTION CEASES FOR A' PER:I.OD,¢:OR:"I$O 'DAYS~:,OR'ZF~"PJ3NS,TRUOTT:ON FAILS TO MEET ALL <br />REQUIREMENTS OF STATE LA..N~. A~.I~. f,~RION COUNTY :BUILDING ..AND' ZONING ORDINANCES, THIS PERMIT <br />SHALL BECOf4E NULL AND VOID. N\!'? . ~ :' '" ' .... . .:'i: <br /> <br />REMARKS: RES R~6958 ........... ' ....... <br /> <br />DONALD E. F;OODLEY, MARION COUNTY ¢U, ILDING OFFICIAL / BY _- ................ <br /> <br />FORM # MC t5-~6 REV fl/88 OFFICE COPY <br /> <br /> <br />