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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 the authorized rep esen a ye <br /> of a registered budder. <br />The work wifl be performed by a registered bvIIder, ' <br />Other <br />I have read end agree to the terms stated on the reverse side of <br />this document. <br /> <br /> DATE: 09/29/92 TIME: 9:24:14 <br /> <br /> ] 'K~× 'EO¥~ ! GATEGORY; <br />i°w~~:KLEIN, LARRY I ,56401000 ~ RESIOENTIAL <br />sn'us ~OD~SS: ........ <br /> <br /> 9784 HILL CREEK RD SE <br /> <br /> m <br />~:USE'OF BUILDING: <br /> <br /> 9804 H[LL CREEK R0 SE ~ ................................................................. <br /> ~UHSV[LLE, 0R SITE NUMBER: <br /> PHONE: 749-2405 ~ V~LU~T~0N: <br /> <br /> TYPE: ELECtRICaL PERMIT OE ~PPL~O~TION NO: 42511 <br /> <br />CONTRACTOR, NO. <br />LICENSE NO: <br />KLEIN. LARRY <br />9804 HILL CREEK RD SE <br />AUMSVILLE, OR <br />PHONE: 749-2405 <br /> <br /> ITEM <br />MANUFACTUREO HOME SERVICE/FEEDER <br />ELECTRICAL STATE SURCHARGE <br /> <br />SUPERVISING ELECTRICIAN/NUMBER <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />ThIS,RECEIPT <br /> <br />BALANCE DUE <br /> <br />QUANTITY AMOUNT <br /> 1 $40.00 <br /> $2.00 <br /> <br />RECEIPT NO: <br /> <br />$42.00 <br />$42~00 <br /> $0.00 <br /> <br />$0.00 <br /> <br />PAYEE: <br /> <br /> RECEIVED BY: P8 <br /> ................. ~:-~_~-:~__~:::~__~:~_~:~:_. TYPE: CHECK ~- 0 <br /> <br />* THIS IS A VALID PERMIT *. THIS,PERMIT EXPIRES 180 OATS FROM ITS ISSUE OATE. IF <br />OORST~UC¥IOR CEASES FOR A. PERIOD OF*~80 DAYS,. OR:IF CONSTRUCTION FAILS TO MEET ALL <br />REQUIREMENTS OF STATE LAWS RND MAR)OR COUNTY BUILDING AND ZONING ORDINANCES, THIS PER~IT <br />SHALL BECOME RULL AND VOID. <br /> <br />REHARKS: HFG SVC FOR HDSP <br /> <br />DONALD E. NOODLEY, ~ARION COUNTY BUILDING OFFICIAL / BY <br /> <br /> OFFICE COPY <br />FORM # MC 1 (i.~ REV, 4/~o <br /> <br /> <br />