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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 RM, - 8:00 A,M, <br /> <br />J have read and agree to the terms stated on the reverse side of <br />thia document <br /> <br />SIGNATURE OF APPLICANT~ <br /> <br /> DATE: <br /> <br />ow~TE: 10/18/89 TINE: <br /> <br /> CITY OF DETROIT <br />SITUB ADDRESS: <br /> <br />1:40:50p <br /> <br />TAX LOT: <br /> <br />CONSTRUCTION TYPE~ <br /> <br /> I} E % ROI % <br /> <br />USE or BUILDING: <br /> <br />FOREST ST <br /> <br />OR 97342 <br /> <br /> CONTRACT CITY: <br /> <br />DETROIT <br /> <br />UGB: <br /> <br />NO <br /> <br />CATEGORY: <br /> <br />OCCUPANCY: <br /> <br />COMMERC I AL.. <br /> <br />OCCUPANT LOAD: <br /> <br /> NO OF BEDROOMS: <br /> <br /> PHONE: <br /> <br />LOT: <br /> <br />WIDTH <br /> <br />BLOCK: <br /> <br />DEPTH: <br /> <br /> SITE NUMBER: 8641 <br /> VALUATION: <br />SECTION: ~WNSHIP: RANGE: ZONEI <br /> <br />AREA: UNITS: IRREG. ~T~ OORNEFt: <br /> NO NO <br /> <br />MAP: <br /> <br />YYPE: ELECTRICAL <br /> <br />CONTRACTOR, NO_ 10875 <br />LICENSE NO: <br />CHERRY CITY ELEC <br />PO 8OX 12688 <br />SALEM ORE 97309-0668 <br />PHONE: 399-7609 <br /> <br />PERMIT OR APPLICATION NO; 19691 <br /> <br /> SUPERVISING ELECTRICIAN/NUI'49ER <br /> JON J WOLF <br /> <br /> ITEM <br />C/I SERV 'TO 100 Af4PS <br />FLEET SURCHARGE -ZONE ? <br />ELECTRICAL STATE SURCHARGE <br /> <br />QUANTITY AMOUNT <br /> 2 $90.00 <br /> $8_96 <br /> $4.$0 <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />$103.46 <br />$92_96 <br />$0.00 <br /> <br />BALANCB'[]UE $10.50 <br /> <br />PAYEE: RECEIPT NO: <br /> <br />RECEIVED BY: CL ............................ TYPE: CHECK ~: <br /> <br /> THIS IS NOT A REMIT. ]]-I~'$'AP~LIOATION NLIST GO THROUI:D4 A REVIEW PROCESS WHERE THE <br />FOLLOWING I¢~UST BE COI~IPLE~EB~,,' IT IS THE RESPONSIBILITTM OF THE APPLICANT TO A,.S,SURE THAT <br />ALL NECESSARY INFOR~%~TION: HAS BEEN RROV~DED. <br /> <br />PLAN REVIEW: BY DATE <br /> <br />CIT~ JURISDICTION: 8Y .............. DATE <br /> <br />REMARKS: 2 - FEEDERS 100-200 AMP R~7885"'CHG'TO 2 -100 AMP SERVICES <br /> <br />COPY <br /> <br /> <br />