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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 PM. - 8 00 AM <br /> <br />SIGNATURE OF APPLICANT ..... <br /> DATE <br /> <br />ow~TE: 10/04/89 <br /> DORA, N, TOM <br /> <br />TIME~ 11:15~04a <br /> <br />TAX LOT <br /> <br />CONSTRUCTION TYPE <br /> <br /> 825 9TH <br /> AUIV~. VI LLE <br />USE OF BUILDING <br /> <br />OR 97326 <br /> <br /> CONTRACT CITY <br /> <br />AUMSVILLE <br /> <br />UGB <br /> <br />NO <br /> <br />MAILINI~ ADDRESS <br /> <br />¢O 8OX 185 <br />SUBLIMITY OR 97385 <br />PHONE: 769-7364 <br /> <br />LOT BLOOK SECTION TOWNSHIP <br /> <br /> SITE NUMBER: <br /> VALUATION: <br />RANGE ~ONE <br /> <br />MAP <br /> <br />NO NO <br /> <br />RESIDENTIAL <br /> <br />NO OF BEDROOMS <br /> <br />TYPE: ELECTRICAL <br /> <br />CONTRACTOR, NO. <br />LICENSE NO: <br />DORAN, TOM <br />PO BOX 185 <br />SUBLIMITY OR 99385 <br />PHONE: 769-7364 <br /> <br />PER~IT OR APPLICATION NO: 19409 <br /> <br /> 5LIPERVISING ELECTRICIAN/NUNBER <br /> <br /> ITEM <br />TEI4P CONSTR SERVICE <br />FLEET SURCHARGE -ZONE 3 <br />ELECTRICAL STATE .SURCHARGE <br /> <br />RAYEE: DORAN, TO~I <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />QUANTITY AMOUNT <br /> 1 $30.00 <br /> $3.84 <br /> $1.60 <br /> <br />$35.34 <br /> $ooo <br />$35.34 <br /> <br />BALANCE DOE $o_o0 <br /> <br />RECEIPT NO= 20581 <br /> <br />RECEIVED BY: PS TYPE: IN CHECK ~ 0 <br />* THIS IS A VALID PERMIT $ :THIS PERMIT EXPIRES 180 DAYS FROM ITS ISSUE DATE. IF <br />CONSTRUCTION CEASES FOR A' PERIOD OF 180 DAYS, OR IF CONSTRUCTION FAILS TO MEET ALL <br />RE(~JIREMENTS OF STATE LAW~ AND MARION COUNTY BUILDING AND ZONIN6 ORDINANCES, THIS PERMIT <br />E~HALL BECOME NULL ANDVOID. <br /> <br />REMARKS: TE~P <br /> <br />DONALD E, NOODLEY, MARION COUNTY BUILDING OFFICIAL / BY <br /> <br />FORM ¢¢ MC 1550 REV IT'~. OFFICE COPY <br /> <br /> <br />