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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 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />Qther ...................... <br /> <br />SIGNATURE OF APPLICANT: <br /> DATE: <br /> <br />owBL~TE = 10/25/90 TIME: 15:26:54 <br /> <br /> RANDY FULTZ CONS'I'RUCTZON <br />SITUS ADDRESS: <br /> <br />TAX LOT; <br /> <br />CONSTRUCTION TYPE: <br /> <br />CATEGORY: <br /> <br /> RES i DEN'I' IAi-. <br /> <br /> 5983 ~a, LINA COUR'F <br /> AUI~CV I LLE <br />USE Of~ ~UI[.DIN~: <br /> <br />OR <br /> <br />97325 <br />........... MARION COUNTY NO <br /> <br />OCCUPANT LOAD: <br /> <br />, SUBDIVISION: <br /> <br />ROLLING GREEN ES'FATES WEST <br /> <br /> PHONE= 789-5386 <br /> <br />LOT: E~LOCK: <br /> <br /> 155 <br /> <br /> SITE NUf~IB ER: 10585 <br /> VALUA~ ION *. <br /> SECTIOR: TOWNSHIP: : RANGE: ;~ON E: <br /> <br /> AREA: ~") UNITS: ~'~ ¢IRREG. LOT[ 2W 8dRNE~: AR <br />4 ~.2 ~ ~ Y~ NO <br /> <br />MAP: <br /> <br /> 49 <br /> <br />TYPE: ELECTRICAL PERf~iT OR APPLiCATi(JN NO: 28324 <br /> <br />6X.~TRACTOR, NO. 2075 <br />LICENSE NO~ <br />NOR'I'HSiDE ELECTRIC <br />PO BOX 7124 <br />~LEM, OREGON 9?303 <br />PHONE: 393-5559 <br /> <br />SUPERViSiNG ELECTRICi,a.N/NUFlYSER <br />ARLIN E. A~ON /14795 <br /> <br /> I'TE~M <br />R~ WIRING < 1500 ~ FT <br />RF_~ ~IRiNG ~ ADDITIONAL 500 ~ Fl' <br />ELECTRICAL STATE ,fSURCHARGE <br /> <br />PAYEE: NORTHSIDE ELECTRIC INC <br /> <br />TO'fALA,..~E'-<-<-<-<-<-<-<-<~ED FEES <br />PREVIOUS RECEIPTS <br />I'HiSRECEiPT <br /> <br />ck~dAN'f'll'Y ~O'UN'r <br />1 $85.oo <br />1 $15.00 <br /> $5.oo <br /> <br />$105.00 <br /> $o.oo <br />8to5.00 <br /> <br />BALANCE r, xJE $0.00 <br /> <br />RECEIPT NO: 29924 <br /> <br /> RECEIVED BY: CL TYPE: CK CHECK ~t 8~55 <br />~ THIS tS A VALID PERMIT ~':'TH[SPEi;~4IT EXPIRES 180 DAYS FF~tfl ITS ISSUE DATE. IF <br />CONSTRUCTION CEASES FOR A PERtODOF 180DAYS, ORIFCONSTRUCTION PAILS TO ~EET ALL <br />REX;~UiRE~IENTS OF STATE ~ COUNTY BUILDIN~ AND ZONIN~ ORDINANCES, THIS PEFa~iT <br />,~,"IALL BECOME NULL AND VOID. <br /> <br />I~Ef4ARK%: RE~ R~4285 <br />DONALD E. WOOOLE~, ~ARiON COUNTY BUILDING OFFICIAL / BY .............................. ~ .................................................. <br /> <br />FORM # MO 15-56 REV. 4/94) <br /> <br />OFFICE COPY <br /> <br /> <br />