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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 />~ am performing work on a property I own or occupy. <br />I am a registered builder OR ( )fheauthorizedrep~esentative <br />of a registered builder. <br />The work wilt be performed by a registered builder. <br />Other <br /> <br />OWN~,~P,.:: i '1/20/91 :~:It4E: 15:02:38 <br /> L ]CKNOOO, MARY <br /> <br />TAX LOT: <br /> <br />CONSTRUCTION TYPE: <br /> <br /> CATEGORY: <br /> <br />OCCUPANCY: <br /> <br /> 12962 ARNDf' ROAD NE <br />.~,UI;~)RA OR 9?'002 <br /> <br /> CONTRACT GITY: UGB: <br /> <br />MAR,~ ON .CQUNTY ..; NO <br /> <br />OCCUPANT LOAD: <br /> <br />MAILING ADDRESS: <br /> <br /> PHONE; 6?8-5484 <br /> <br />LOT: BLOCK: <br /> <br />SECTION: : TOWNSHIP: <br /> <br />~iT'E NUMBER: 14925 <br />VALUAi/'iON; <br />RANGE; ZONE: <br /> <br />MAP: <br /> <br />, ARBA: :UNITS; 'IR~, LOT: CORNER: <br /> NO NO <br /> <br />I'YPE: ELECTRICAL <br /> <br />CONTRACTOR, NO- <br />LICENSE <br />~ 3CKNOOD MARY <br /> <br />PER~i'f' OR APPLICAFiON NO: 38923 <br /> <br /> SUPERVISING ELECTRiCIAN/NUMBER <br /> <br />PHONE: 6?8-5484 <br /> <br />~ERViCE/FEEDER 101 [0 400 AMP~ <br />:LECTRIC.,L STATE SURCHARGE <br /> <br />PAYEE: LOCKNOOO, MARy <br /> <br />TO'rAg A~E3~EO P'E~ <br />PREV.[r..~S RECEiPT~ <br />'f'Hl$ RECEIPT <br /> <br />QUANf' L I Y AMO(JN'I' <br /> $B0. O0 <br /> $3. go <br /> <br />BALANCE DUE $0.00 <br /> <br />RECE.[PT NO: 388?5 <br /> <br /> RECEIVED BY: DM2 "YPE- CK CHECK =. <br /> <br />CONSTRUCTION CF_A~ FOR A PER[ODOF180 IBAY~, OR [~ COR~TRUCT[ON FAILE. TO ~EE'f ALL <br />~(~XJ[REI~T$ OF STATE ~ .N'~IO RAR[ON COUNTY BUILDING AND ZONING ORD[NANCES. THIS PE'R~iT <br /> ALL BECOME NULL AND VOID. <br /> <br />REMARKS; 200A 3ERV CHGE R~39'71 <br /> <br />DONALD E_ NOODLEY. MARION COUNTY BUiLDiNG OFFICIAL <br /> <br /> OFFICE COPY <br />FORM # MC 15-56 REV. 4/90 <br /> <br /> <br />