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MARION COUNTY BUILDING INSPECTION SENATOR BLDG, NO, 225 220 HiGH STREET NE SALEM, OREGON 97301 PHONE: 588-5147 8:00 - 4:30 24 HOUR CODE-A-PHONE: 588-7904 of a registered builder. The work will be performed by 8 registered builder. Other DATE: 10/08/9~ TINE: 9:06:09 ,OWNER'. NAWORTN, DON ;TAX LOT'. : ~,~,~EI,IrIAL SITUS ADDRESS; TYPE; OCCUPANGY: i 1192~ FARGO ED NE : MAiLiNG AObRE~i ..................... SUBDIWS~ON: SAME PHONE: 678-5~13 SITE HUMBER: 93-~2&52 VALUATION: r 4 4S 1W EF'U 4 TYPE= ELECTRICAL CONTRACTOR~ NO. 42047 LICENSE NO: Clarence L Kenagy 111NW 2nd Canby, ~701~-0000 PHONE: 26~-8828 ITEM PERHIT OR APPLICATION NO: 58§~8 SUPERVISING EI. ECTRICIAN/NUflBER QUANTITY AMOUNT ., BRANCH CIRCUIT, WITHOUT SERVICE OR FEEDER - 1ST CIRCUIT 1 $35.00 BRANCH CIRCUIT~ WITHOUT SERVICE (IR FEEDER EACH ADDITIONAL 4 $8.00 ELECTRICAL STATE SURCHARGE $2,15 TOTAL ASSESSED FEES $45.15 PREVIOUS RECEIPTS $0.08 THIS RECEIPT $4S.15 BALANCE DUE $0.00 PAYEE: Clarence L Kenaqy ~ RECEIPT NO: 52~34 R~CEIVED~BY:.id -- . . ://~==:=:...: -- - TYPE, CK CHECK ~: S272 ............... ::::::::-::-:- --=:::::--:2:-:: .................................................... * THIS IS A VALID PER~IT * THIS PERNiT EXPIRES 18~ DAYS FROM ITS ISSUE DATE. IF 6OHSTRU6TIOH CEASES FOR A PERIOD OFiS~ DAYS~ OR IF COHSTRUCTISH FAIL~ TO flEET ALL REgUIRE~EHTS OF STATE LA~S AND NARION COUHTY 9UILDIN~ AND ZOHIH6 DRDIHA~CES~ THIS PE~HIT SHALL RECOHE HULL AND VOID. REMARKS: 5 BR CIR DONALD E. WOODLEY.~ MARION COUHTY BUILDING OFFICIAL / BY ............................... OFFICE COPY FORM # MC 15-56 REV. 4/90