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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br />t ) <br /> <br /> PHONE:588-5147 8:00- 4:30 <br />Il am a registered builder OR ( ) tho authorized rep,:esentative SIGNATURE OF A~'PLIOANT~ v ~ ~ <br /> <br /> of 8 registered builder, <br /> The work will be performed dy a registered builder, <br /> Other <br /> ~ have read 8nd 8gree to the terms stated on the reverse side of <br /> this document. <br /> <br /> ')ATE: )8/28/92 TIME: 1.6:02:09 <br /> <br />OWNER: <br /> PITTERL. E, ELISE ~. <br /> <br />SITUS ASDRESS <br /> <br /> 2375 t".HAMPOEG RD NE <br />A I.J I.",' 0 R A OF 9700'2 <br /> <br />USE OF BUILDING'. <br /> <br />MAILING ADCRESS; <br /> <br />Z0569 CHAMPOEG RD <br />AURORA, OR 97002 <br />PHONE: 678-i22B <br /> <br />Th× LOT CATEGORY: <br />40263000 COMMERCIAL <br /> <br />CONSTRUCTION TYPE: OCCUPANOY~ <br /> <br />c~j~' ~T~t HTY ul~ OCCUPANT LOAD: <br /> NO OF BEDROOMS <br /> <br />SITE NUMBER.' 92-01859 <br />'~LUAI' ION: <br /> <br />LOT; BLOCK: SECTION <br /> <br />TOWNSHIP; RANOE ZONE: MAP: <br />4S lW EFU 4 <br />UNIT~:c '~)G -OT CORNER:MO <br /> <br />TYPE: ELECTRICAL <br /> <br />CONTRACTOR~ NO. <br />LICENSE NO: <br /> CANBY PLUMBING <br />805 NE 4TM <br />CANBY, 97013 <br />PHONE: 266,-2091 <br /> <br /> PERMIT OR APPLICATION NO: 4igOO <br /> <br />33572 SUPERVISING ELECTRICIAN/NUMBER <br /> <br /> I'rEM <br />SERVICE/FEEDER LESS THAN 200 AMPS <br />BRANCB CIRCUIT, WITH SERVICE OR FEEDER <br />ELECTRICAL STATE SURCHARGE <br /> <br />PAYEE: PII'TERLE, ELISE K <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />QUANTITY AMOUN1 <br />i $50.00 <br />17 $34_00 <br /> $4.20 <br /> <br />$88.20 <br /> $0..00 <br />$88..2(.) <br /> <br />BALANCE DUE $0.00 <br /> <br />RECEiRT NO: 44286 <br /> <br />RECEIVED BY: cl TYPE: OK CMECK ~:: 2363 <br /> <br />* THIS IS A VALID PERMIT * THIS PERMIT EXPIRES 180 DAYS FROM ITS ISSUE DATE. iF <br />CONSTRUCTION CEASES FOR A PERIOD OF I80 BAYS, OR IF CONSTRUCTION FAILS TO HEET ALL <br />REQUIREHENTS OF STATE LAWS AND MARION COUNTY BUILDING AND ZONING ORDINANCES, THIS PERMIT <br />SHALL BECOME NULL ANO VOID. <br /> <br />REMARKS: 200 AMP SVC 17 CIR <br />OONALD E. WOODLEY, MARION COUNTY BUILDING OFFICIAL / BY ............ l~.~.~. ....................... <br /> <br /> OFFICE COPY <br />FORM # MC 15-56 REV, 4/90 <br /> <br /> <br />