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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO, 22.5 <br />220 HIGH STR,6.,ET NE <br /> SALEM, O'~EGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am performing work on a property I own or occupy. <br />Iarn a registered builder OR the authorized reBresentative <br />of a reglstered builder, <br />The work will be performed by 8 registered builder. <br />Other_ <br /> <br />this document, <br /> <br />SIGNATURE OF APPLICANT: <br /> DATE: <br /> <br />OWN Fg~'f'E _' 02/04/92 'f'IMEt <br />SrTUS AD 0RES,.~~:~ ~CI~'ER * <br /> <br />13~28~08 <br /> <br />TAX LOT: CA FEGOFIY: <br />CONSTRUCTION TYPE: OCCUPANCY: <br /> <br />RE~Z ~t::N T' IAL <br /> <br /> CONTRACT CITY: : UGB; OCCUPANT LOAD: <br />20812 OLJV~'f'F.;AO ROAD NE <br />AURORA OR 97002 <br />NSE OF BUILDING: ~ARiON COUNTY NO No or ~EUI~}OBS: <br /> <br />MAiLiNG ADDRESS: SUBD VISION' <br /> <br /> I~H~'~l~: SI I'E NUMBER*. 92-0054? <br />LOI: BLOCK SECTION TOWNSHIP RANG~A~UAI' '----' '--~ ~: ZONE. MAP. <br /> <br />NO <br /> <br />TYPE'- ELECTRICAL PERMIT OR APPLICATION NOt <br /> <br />~,8~02 <br /> <br />CONI'RAC I OR, NO. 20919 <br />L i CE.NSE NO: <br /> Bear' Electric inc <br />Po Box 389 <br />O<2na'td, 97020-0000 <br />PH~E: 678~1355 <br /> <br />SUPERViSiNG ELEC'f'R i C J;AN/NUMB ER <br /> <br /> il'EM <br />5ERViCE/FEEOER ]01 TO 400 AMP~ <br />ELECTRICAL STAFE SURCHARGE <br /> <br />QUAN f'i TY A~OUN T' <br /> 1 $60 _00 <br /> $~, 00 <br /> <br />'['OTAL ~E~EO FE~ <br />PREVIOUS RECEIPTS <br />THiS RECEIPT <br /> <br />$63.00 <br /> <br />BALANCE OUE <br /> <br /> RECEIVED BY: OM2 ........................................................................................................ TYPE= CK CHECK ~: 88?5 <br /> <br /> ~ THIS IS A VALID PEF~iT $ THiS PER~I~T EXPIRES 180 DAY~ FROM iT8 <br />~ST~CT~ C~ES ~R A PERIOD OF 180 DA~, OR JF ~ST~CTI~ FAi~ TO NEET ALL <br />REdIReCTS OF STATE ~ ~B ~RJ~ ~NTY BUiLDiNG ~D Z~ING ORDiNaLS, THiS PE~iT <br />~ALL B~E NULL ~D VOID. <br /> <br />REMARKS: REPLACE MOBILE HOME INTERIOR PANEL DUE '['O FiRE <br />E,X2~ALD E. ~¢OODLEY, MARION C~JN'f'Y 8U~LD~NG OFFICIAL / BY <br /> <br />OFFICE COPY <br /> <br /> <br />