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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PP~ON E 588-5147 <br />COD~'-A-PHONE 4::30 PM - 8::00 A M, <br /> <br />I aln performing work on a property I own or occupy <br />lamarOglStered builder OR( ~theautllobzed representative <br />of a re¢~lsterod budder <br />The work will be performed by a registered builder <br /> <br />SIGNATURE OF APPLICANT <br /> DATE <br /> <br />1/o9/89 <br />DORAN, TOM <br /> <br />TIME: 2:52:15p <br /> <br />TAX LOT <br /> <br />CONSTRUCTION TYRE <br /> <br />90040-130 <br /> <br /> UGB <br /> <br /> NO <br /> <br /> 815 9TH <br /> AUMSVILLE <br />US~ OF BUILDING <br /> <br />OR 9?325 <br /> <br /> CONTRACT CITY <br /> <br />AUMSVILLE <br /> <br />PO BOX 185 <br />SUBLIMITY OR 97385 <br />PHONE: ?69-7364 <br /> <br />LOT BLOCK SECTION TOWNSNIP <br /> <br /> DELMAR Iii <br /> <br />SITE NUMBER: <br />n*~'~UATION: ZONE <br /> <br />9521 <br /> <br />WIDTH 14 DEPTH 4 AREA 25 UNITS 8S <br /> 57 71 SF <br /> <br />IRRBG LOT 2W CORNEn ~ <br /> <br /> YES YES <br /> <br />CATEGORY <br /> <br /> ~ZS~DENTI~L <br /> <br />MAP <br /> <br />TYPE: ELECTRICAL PERMIT OR APPLICATION NO: <br /> <br />20166 <br /> <br />CONTRACTOR, NO. 2075 <br />LICENSE NO; <br />NORTHSIDE ELECTRIC INC <br />PO BOX 7124 <br />SALEM, OREGON 97303 <br />PHONE: 392-5559 <br /> <br />SUPERVISING ELECTR~CI,~d'4/NUMSER <br />ARLIN E. ADAMSON /1479S <br /> <br /> ITEM <br />RES WIRING < 2000 SQFT <br />FLEET SURCHARCE -ZONE 3 <br />ELECTRICAL STATE SURCHARGE <br /> <br />OUANTITY AMOUNT <br /> $75.00 <br /> ~3.84 <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />$82.59 <br /> $o.0o <br />$82_59 <br /> <br />PAYEE~ NORTHSIDE ELECTRIC INC <br />RECEIVED BY: P8 <br /> <br />BALANCE DUE <br /> <br />RECEIPT NO: 21404 <br />TYPE: CK CHECK ~: 6263 <br /> <br />~ THIS IS A VALID PERI, IT · THIS PEI:~IIT EXPIRES 180 DAYS FROM ITS ISSUE DATE. IF <br />CONSTRUCTION CEASES FOR A PERIOD OF 180 DAYS. OR IF CONSTRUCTION FALLS TO MEET ALL <br />RE(~JIRE~IENTS OF STATE LANS AND I~IARION COUNTY BUILDIN8 AND ZONING ORDINANCES, THIS PER~4IT <br />SHALL DECOfilE NULL AND VOID. <br /> <br />RE~RI<S: RES R~8263 <br /> <br />DONALD E. NOODLEY. MARION COUNTY BUILDING OFFICIAL / BY <br /> <br />OFFICECOPY <br /> <br /> <br />