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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 /> <br />I am a registered builder OR the authorized representative SIGNATURE OF APPLICAN'r: <br />The work will be gefformed by a registered builder. ., X,l /~ <br />this document, <br /> <br /> BOBs Y MARKEI : : COMMERCIAL. <br /> <br />022? rS'fAY'TON RD SE CONTRACT CITY: , UGB: OCCUPANT LOAD: <br />AUMSVi LLE OR 9?325 <br />~OYED~N~ "MAR'iON COUNT'Y NO m0 oF BEDROOMS: <br /> <br />~AME <br />PHONE: 1'69-2308 ~i'f'E NUf~B~R: 92-01535 <br /> <br /> NO ! <br /> <br />TYPE; ELECTRICAL <br /> <br />CONTRACTOR, NO. 45109 <br />LICENSE NO: <br />DAVID STURGEON <br />41354 RIDGE DR <br />SCIO, 9?374-0000 <br />PHONE= 769-3724 <br /> <br />PERMIT OR APPLiCATioN NO: 39442 <br /> <br /> SUPERVISING ELECTRiCIAN/NUMBER <br /> <br /> I']'EM <br />SERVICE/~EEOER LESS '['MAN 200 A~ <br />8RANCH CiRCUi'f', Ni'rH SERVICE OR FEEDER <br />ELECTRICAL STATE 5~URCHAR~E <br /> <br />QLIAN'rI'r¥ AMOUNI' <br /> $ $150.00 <br /> 28 $55.00 <br /> $10.30 <br /> <br /> TOTAL ~E~ED FEES $216.30 <br /> PRE¥1OUS RECEIPTS So.s0 <br /> THiS RECEIPT $216.30 <br /> <br /> BALANCE DUE $0_00 <br /> PAYEE: DAVID S'I'UR~Ij~;¢~ [~ RECEIPT NO: 41485 <br /> <br /> ~ THiS iS A VALID PE~T * THIS PE~iT ~RZR~ 180 ~YS F~ ITS ~E <br />~ST~CTi~ C~ FOR A PERIOD OF 180 ~¢ OR 1F ~STBCTI~ FAI~ TO MEET ALL <br />~IR~T~ OF STATE ~ ~D ~R~ ~NTY BUiLDiNG ~D Z~1N~ ORDIN~C~, THIS PE~iT <br />~ALL BEdE NULL ~D VOID. <br /> <br />REMARKS: 2/GER 1/FEEDER 28/CIR <br /> <br />DONALD E. NOODLEY, MARION COUNTY BUILDING OFFiCiAL / BY <br /> <br /> OFFICECOPY <br />FORM # MC 15-~ REV, 4J~ <br /> <br /> <br />