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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO, 225 <br />220 HIGH STRGET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br /> 24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />~ ~m performing work On ~ property I own or occupy, <br />I am 8 registered bu{Ider OR ) the authorized representative SIGNATURE OF APPLICANT;~'~__.~:_ <br />of a registered builder. <br />The work will be performed by a registered builder, <br />Other <br />I have read and agree to the terms stated on the reverse side of ¢ DATE; <br />this document. <br /> <br /> DATE: 08/24/?3 TIME: 9:15:30 <br /> <br /> AOMSVILL. E OR 97S2~ ! R~J~rNCI~O~UNTYI f'~ ~ ' ~" <br />:O§~ o¢ ~0 rb ~ - <br /> <br />SU8OIVlStONt <br /> <br />PHONE: 709-595~ <br /> <br />SITE HUMBER: <br />VALUATION: <br /> <br />TYPE: ELECTRICAL PERHIT OR APPLICATION NO: 49~5& <br /> <br />CONTRACTOR~ NO. SUPERVISING ELECTRICIAN/NUMBER <br />LICENSE NO: <br />LITTAU~ EUGENE <br /> <br />PHONE: 769~5953 <br /> <br /> ITEM <br />SERVICE/FEEBER LESS THAN 200 AMPS <br />ELECTRICAL STATE SURCHARGE <br /> <br />TOTAL ASSESSEB FEES <br />PREVIOUS RECEIPTS <br />'THIS RECEIPT <br /> <br />QUANTITY AMOUNT <br /> 1 $50.00 <br /> $2.58 <br /> <br />$52.50 <br /> $0.00 <br />$52.50 <br /> <br /> BALANCE ]DUE $0.00 <br /> PAYEE: LITT.AU~ EU~N~' ('~ . RECEIPT NO: 51709 <br /> RECEIVED BY. MB ' ' . ..~ . . TYPE. CA CHECK ~: 0 <br /> ................. ::::::::::::::::::::::::::::::::: ..................................... <br /> ~( THIS IS A VALID PERH~T ~. THIS PERH~T EXPIRES 18~'DAYS FROH ITS iSSUE DATE. IF <br />CONSTRUCTION CEASES FOR ~ PERI~ OF '188.DAYS~ ORIF CONSTRUCTION FAILS TO NEET ALL <br />REGUIREHENTS OF STATE L~S ~NO H~RION ~UN~ 'BUILDIH~ RHO ZONING OROINRNCES= TH~S PER,ST <br />SH~LL BECOHE NULL ~N~ VOID.' <br /> <br />REMARKS: SERVICE ALTERATION <br /> <br />DONAL. D E. WOODLEY, MARION COUNTY BUILDING OFFICIAL / BY <br /> <br />FORM # MC 15-5~ RE'V. 4j90 OFFICE COPY <br /> <br /> <br />