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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 />84 HOUR CODE-A-PHONE: 588-7904 ' <br /> <br />of a regi~,tered builder, <br />The work will be performed by a registered builder, <br />Other__ <br /> <br />this document, <br /> <br /> ow.~n:DATE. 9o/09194 I ~E. 8. ~. ~.~6 TAX LOT; : CATEGORY; <br /> <br /> INC, , , RE,~ IDEI'~TIAL <br />/~lTU~ ADDRE~'. ~ON~TRUCT~ON TYPE' : OOCUPANCY'. <br /> <br /> 95;~1 SHAFF RD SE i'~6'r~YE~E~'~'i~Yi .... <br /> AUMSVIU,,.E ' <br />.......... p.~ ?p~ MARION COUNTY ~NO ~ ...... <br /> <br /> SITE HUHBER~ <br /> PHONE=" '~ <br /> 74~-~ o6 VALUATION: <br /> <br />.... J ......... <br /> <br /> TYPE: ELECTRICAL PERNIT OR APPLICATION NO: 54838 <br /> <br /> COIql'R~CTOR, I10. 0;~964 SUPERVISING ELECTRICIAN/IqUMBER <br /> LICENSE <br /> Johe A <br /> 1~764 Mill Creek Rd <br /> AuMsv~ lle. ~7325-8~0~ <br /> PHONE: 749-2971 <br /> <br /> ITEM ' QUANTITY AMOUNT <br /> SE~VICE/FEE~ER LESS TI.tAN 288 AMPS 1 <br /> ELECTRICAL STATE SURCHARGE ~ $2.50 <br /> <br /> TOTAL A~SESSED FEES <br /> PEEV~OU~ RECEIPTS SB. <br /> : ~ , :THIS RECEIPT $52. <br /> : · : :: <br /> , · BALANCE DUE <br /> <br /> RECEIPT NO: 572~4 <br /> ,PAYEE:RECEiVE~JOhnBy: ApH2S~eer fYPE:: CK CHECK ~: 145~ <br /> <br />COHSTRUCTZON CEASES FOR R PER'iBO OFIS~ 9AYS,::OR ZF :~oNSTRU~TION FALLS TO HEET ALL <br />SHRLL ~ECOHE NULL AHD VOID,:' , <br /> <br /> REMARKS:: SER <br /> <br />DONALD ~. WOODLFY.~ MARION COIJNTY BUILBING OFFICIAL / BY <br /> <br />FORM # MC 15-56 R~, 4~0 OFFICE COPY <br /> <br /> <br />