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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 />I 8m pecforming work on a property t Own or occupy <br />t 8m a registered bui~er OR the ~uthodzed rebresentative <br />of a registered builder. <br />Tl~e work will be performed by a registered builder. <br />Other <br /> <br />SIGNATURE OF APP <br /> <br />m 88~ 'bmT~: jdO~UPANT LOAD: <br /> <br />SAi4E <br /> SITE NUMBER: 74-~884S <br />F'HONE: 362-8447 VALUATION: <br /> <br />TYPE= ELECTRICAL <br /> <br />CON'TR~CTOR~ NO. <br />LICENSE NO: <br />HAMPTON, KELLY & VERNON <br />SAHE <br /> <br />PHONE: S62--0447 <br /> <br />PERMIT OR APPLICATION ND: 53958 <br /> <br /> SUPERVIS:[NG ELECTF~ICIAN/NLIHBER <br /> <br /> El'EM <br />8ERV:[CE/FEE~ER LESS 'ri"lAN 20e AMPS <br />BRAI~CH ~IRCI.IIT~ WITH SERVICE OR F:'EE]f)ER <br />ELt::;L, TRIf, AL STATE SUROHARGE <br /> <br />QUANTI'rY AHOUNT <br />1 $50,, 00 <br />6 $12,00 <br /> <br />TOTAl. ASSESSE;Q FEES $65.10 <br />PREVIOUS RECEI~F'TS $8.00 <br />THIS.. RECETpT $6%, 10 <br />BALANCE DOE <br /> <br /> PAYEE: HAMF'TON~ KELLY & VERNON RECEIPT NO: 564:[! <br /> RECEIVE[) ~Y: PM TYPE: CA CHECK :~: 0 <br /> ..................... ::~_~;~_;:::=:::=~;;~::2~::,,-:~- ~ . . ............................................................................. <br />$ THIS IS A VALID PERMIT · THIS PERMIT EXPIRES 188 DAYS FROM ITS ISSUE BATE. IF <br />CONSTRUCTION CEASES FOR A'PEEIO~ OF 188 DAYS, OR IF COHSTRUCTION FAILS TO MEET ALL <br />REQUIREMEMTS OF STATE LAMSAND NARION COUNTY BUILDIN~ AMD ZONING ORDINANCES, THIS PERMIT <br />SHALL BECOME MULL AH~ VOID. r <br /> <br />REMARKS: <br /> <br />DONAL. JB E:,i I~JOOJOIi,,I,~¥,¢ MARl;ON COUN-f'Y BULl;Lb)LNG OFFICIAL / ]BY <br /> <br />FORM # MO 1 ~-5~ R~V. 4/90 OFFICE COPY <br /> <br /> <br />