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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET ~ <br /> SALEM, OREGO?,..97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br /> 24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am performitl9 work on a property I OWn or O0¢upy. <br />I am 8 registered builder OR the ~uthorlzed representative <br /> <br />OWN~.~'~E: lt~/'~7/9't )iNIE; 18:04:19 <br /> <br /> ,A ...¢AN(,E, JEFF <br />SITUS ADDRESS: <br /> <br />RESI OEi'4 .A. <br /> <br /> AURORA OR <br />use o~ BUr~-DINC~ ...... MARION CCX3N'FY <br /> <br />tOT ELOCKi [S~CTION; TOWNSHIP: <br />W~DT~4 OEPTMi AREA: <br /> <br />~i T'L% NU/V~ER~ ' 5254 <br />VAL. UA"¢ 1L,'N: <br />RANGE ZONE: <br /> <br />NO NO <br /> <br />MAP: <br /> <br />f'YPE: ~LEC'f RiCAL PER~4I'T OR APPLICATION NO.* <br /> <br />37681 <br /> <br />CONTRACTOR, NO- 20919 <br />LICENSE NO: <br /> <br />Po Box 399 <br />Dona]d, 97020-0000 <br />Pld(~E: 878"-1555 <br /> <br />SUPERViSiNG ELeCTRICIAN/NUMBER <br /> <br />~RANCM CiRCUiTS - TNO TO TE:N <br />ELECTRICAL SfAf'E SURCHARGE <br /> <br />QUANTif'Y 'l <br /> $2,50 <br /> <br />')'OrAL A~E~EO <br />PREVIOUS REC~iP'~'~ <br />'f'H1$ RECEZP'[' <br /> <br />$52.50 <br /> <br />$52.50 <br /> <br />BALANCE DUE $0_00 <br /> <br /> PAYEE: B~ar E"le¢~rffc Inc RECEiPf NO: 39639 <br /> R~CEiVED BY: [~2 .................................................................................................................. TYP~: CK CHECK ~: 8738 <br /> <br />~ THiS iS A VALID PBRMI'f * 'fHIS ~ER~IT EXPiRF-~ t80 DAYS FROM iTS i,%~AJE DATE. iF <br />~SI'~CT1~ C~ FOR A PER/OB OF 780 DAYS, OR IF ~ST~Ol'I~ FAI~ TO ~EET ALL <br />REdiReCTS OF STATE ~ ~D ~RI~ ~NTY BUILDING ~ Z~iNG OROiN~Og~, fHIS PE~IT <br />~ALL B~E NULL ~O VOI~. <br /> <br />F. Er4ARKJ. 2-10 CJR <br /> <br />])(3NAL[) E_ NOOE)LEY, IV~kRiON COL~N'T'Y 8UIL0tNG OffFIC.]:AL / ~Y <br /> <br /> OFFICE COPY <br />FORM # MC 15-56 REV, 4/90 <br /> <br /> <br />