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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 />SIGNATURE OF APPLICANT: <br /> DATE; <br /> <br />OWNK, JlA'I'E: 05/25/90 'tiME: ?:52.+58 <br /> <br />S~TUS ADDnESSMARION COUNIY ROAD DEPT. <br /> <br />TAX LOT; <br /> <br />CONSTRUCTION TYPE: <br /> <br /> 8900 MILL CREEK ROAD <br /> AU~4,SV~ LLE . OR <br />USE OF BUILOING; AU~VILLE NO <br /> <br />MAILING ADCRESS: <br /> <br />CATEGOHY: <br /> <br />OCCUPANCY: COMMERC~ AL <br /> <br />OCCUPANT LOAU: <br /> <br />BHONE: <br /> <br />LOT: 8LOCK: SECTION: <br /> <br />SiTE NU~ER; <br />nANG~ALUA'f' iCON :: zONE: <br /> <br />10266 <br /> <br />MAP: <br /> <br />NC) <br /> <br />'f YPE:: E'LECI"R l CAL <br /> <br />CON'¥'RACIOR, NO, <br />LICENSE NO: <br />SSM EN'T'ERPR~SES <br />1386 TIMBER ~'~ <br />ALBANY <br />PHONE: 928-3q29 <br /> <br /> P~RIv~i'T' OR APPLiCATiON NO; 24346 <br /> <br />53691 SUPERVISING ELECTRiCIAN/NUMBER <br /> CLARE V. SNiOER <br /> <br /> YrEM <br />TWO OR MORE NEN CiRCUiTS;ALT OR E)<'f' <br />FLEE7 SURCHARGE ~ZONE 3 <br /> ~t. EC'FRJCAL S'[AF~ SURCHARGE <br /> <br />PAYEE: ~M EN'FERPRiSES <br /> <br />TOTAL A~Ig~SEDFE~ <br />PREVIOUS RECEiP'f'$ <br />tHiS RECEIPT <br /> <br />QUAN'f' ~ f'y AMOUN )' <br /> 1 $30.00 <br /> $3,84 <br /> $1_5o <br /> <br />$35,34 <br /> $0.00 <br />$35.34 <br /> <br />BALANCE DUE $0,00 <br /> <br />RECEIPT NO: 25'799 <br /> <br /> RECEIVED BY: OM2 TYPE: CA CHECK ~: <br /> <br />~ THiS IS A VALID PEI~I~T · ~HI~ PF_.J~lIT EX~[RE~ 180 DAY~ FROf,1 ITS l~E ~TE. <br />~ST~CTi~ c~ F~R A PER[OD OF 180 ~, ~ iF ~ST~CTI~ FAi~ TO MEET ALL <br />RE~iR~TS OF STATE ~ ~O ~R[~ ~N~ BU[LDING ~O Z~ING ORDIN~C~, THIS <br />~LL 8~E NULL <br /> <br />REMARKS: 2 CiR R~403 ('~, <br />b~NALD E- ~¢¢OODLEY, MARION COUNTY BUILDING OFFICIAL / BY ~ <br /> <br /> OFFICE COPY <br />FORM # MC 15,$~ REV, 4/90 <br /> <br /> <br />