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MARION COUNTY BUILDING INSPECTION <br /> <br />SEN, <br /> <br /> SAL <br /> <br /> PHONE <br />24 HOUR <br /> <br />I am a registered builder OR ( ) the authorized rep <br />of a registered builder, <br />The work will be performed by a registered builder. <br />Other <br /> <br />I have read and agree to the terms stated on the re <br />this document, <br /> <br />,TOR BLDG. NO. 225 <br />HIGH STREET NE <br />--M, OREGON 97301 <br /> <br /> 588-5147 8:00- 4:30 <br />3ODE-A-PHONE: ~88-7904~'" ~-'~'~ <br />:esentative SIGNATURE OF APPLICANT; <br /> <br />TAX LOT. <br /> <br />~ 'CONTRACT'CiTY. JGB. ',OCCUPANT LOAD' <br /> 888~ SNAW SI~UARE RP SE <br /> AUHoVILi. E <br /> ...................... qB_ ._?_~2~_ ......... ~A~t. gN _¢8O. HTr'( . NO <br /> <br />...... ADDRESS SUBDIVISION: <br /> <br /> SITE NUMBER: 94-ele47 <br /> F I ISNE.. VALUATION.' <br />LOT; ' 'iBI~OC']~; ............... ~0¢i~)'i~; ............... '~W~I~'~'iP~ ......... RANGE ~ ~or~E: ~ MAP'. <br />--4WIDT)ff'. ....................... IDSPTN ~1~; ....... t-~ i~'~{ ........... I~ ~=(~ i CI~R~'~ ~1~;' ' 51 <br /> <br />........................... 7-~--:.-.- AC .............. NO .... NO, <br /> <br />TYPE: ELECTRICAL PERMIT OR APPLICATION <br /> <br />CONTRACTOR, NO. 2745~ <br />LICENSE <br /> R & R Elec(ric <br />PO Box ~2 <br />l'urner ~ 97~92-0000 <br />PNONE: 74~~254~ <br /> <br />SOPERVISING ELECTRICIAN/NUMBER <br /> <br /> ITEM <br />SERVICE/FEEDER LESS THAN 200.Ab <br />BRANCH CIRCUIT, WITH SER¥ICE <br />ELECTRICAL STATE SURCHARGE <br /> <br /> PAYEE: R & R Electr&c Inc <br /> RECEIVED BY: PB <br /> <br /> ~ THiS )S A VALID PERHIT $ TH! <br />CONSTRUCTION CEASES FUR A PERIO~ <br />REQUIREMENTS OF STATE LAWS AHD H~ <br />SHALL BECOHE NULL AND VOID. <br /> <br />REMARKS: 280 AHP 4 CIR <br /> <br />~ONAE.B E. WOODLEY, MARION CouNT <br /> <br /> QUANTITY <br />PS <br />FEEDER 4 <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />BALANCE ~UE <br /> <br />ANOONT <br /> t~50.00 <br /> $8.00 <br /> $2.98 <br /> <br /> $60.90 <br /> $0.00 <br /> $60.90 <br /> <br /> $0.00 <br /> <br /> RECEIPT NO: 58765 <br /> TYPE: CK CHECK t:: 1~.,.~67 <br /> <br />B PERHIT,EXPIRF.~ 18~ DAYS FROH ITS ISSUE DATE= IF <br />DF 188 DAYS, OR IF CONSTRUCTION FA~LS TO NEET ALL <br />EION COUNTY BUiLDiNG AND ZONING OROlNANCES, THIS PERHIT <br /> <br />BUZLDING OFFICIAL / BY ...... ..~,... ..................................... <br /> <br />OFFICE COPY <br /> <br /> <br />