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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG NO 225 <br />220 HIG.U STREET NE <br /> SA'~M, O~EGON 97301 <br /> <br /> PHONE; 588-5147 8:00 - 4::30 <br />24 HOUR CODE-A-PHONE:: 588-7904 <br /> <br />I am a registered builder OR f I the authorized representative <br /> <br />SIGNATURE OF APPLICANT <br /> DATE <br /> <br />owliSh(E: 12/13/90 fi'lvlE: 14:2t-'49 <br /> <br /> GARIBAY, J EEAJ~ <br /> <br />TAX LOT CATEGORY <br /> <br /> 230 EYERGREEN DR -- 3 CONTRACT CITY UGB <br />AUf~SV I L[W OR 9Y325 <br /> AU~Vi LLE NO <br />USE OF BUILDING <br /> <br />SVP2N'GI~I:I~N MOLglL[:[ HOME PARK <br /> <br /> 4305 GARY Sf <br /> KEiZER, OR 97303 <br /> PHONE: 390-22(5? 5IIB NU~gR: 11(~14 <br /> VALUA I ~ ON; <br />LOT BLOCK S~CTION TOWN~NIP RANGE ZONE MAP <br /> <br />WIDTH DEPTH AREA UNITS IRREG LOT CORNER <br /> 55 92 5050. ~P NO NO <br /> <br />TYPE~ ELEC I'RtCAL <br /> <br />CON I RAC! OR, NfO. <br />L,[ CEN~.E NO: <br />JUDSON ' S ,[NC <br />PO 8OX 12,869 <br />SALEM, OR 9?309 <br />PHONE: 363-4 141 <br /> <br />5ERVJCE/FEEDER 10~ ro 400 <br />ELEC]RiCAL S[AIE SURCHA~,¢6 <br /> <br />PAYEE: ,JUD"',',',',',',',',','3ON ',~ <br />1,4EC~JVED BY: PR <br /> <br />QUANII[Y AM[TUNf <br /> <br />'IOrAL ~E,,~ED PEE~ <br />PRE¥IOU~ RECEIPF~ <br /> <br />$63.00 <br /> <br />BALANCE DUE $0-90 <br /> <br /> RECEIPT NO: $0949 <br />TYPE: CK CHECK ~: 1~024 <br /> <br />* fHl8 t~ A VALID PERI¥11T * THI~ PE~IT EXPIRES 180 OAYr~ PR~ IIS I~UE DA'f6. iP <br />CONSTRUCTION CEA~E~ FOR A PERIOD OE 180 DA~, OR IF OONS1RUC'fION FAIL8 TO ~EET ALL <br />R~iRE~EN1E OF STATE LA~ AND ~RiON COUNTY BUiLDiNG AND ZONING ORDiNANCe. 1HI~ FERMi1 <br />,~HALL BECf.)~IE NULL AND VOID. <br /> <br />R~ARKS; <400 AMP SERVICE R~3435 <br /> <br />C~NAL{] E. ~OO[]LEY, MARION COUN[Y BUiLDiNG OFFiCIAL/ MY <br /> <br /> OFF[CE COPY <br />FORM # ~C 15-56 REV 4~90 <br /> <br /> <br />