Laserfiche WebLink
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 am performing work or~ a property I own or occupy. <br />I am a registered builder OR the authorized represen a ire <br /> of a registered builder, <br />The work Wilt Be performed by a regi,stered builder, <br />Other <br />I have read 8nd agree to the terms stated on the reverse side of <br /> <br /> I:~E S ]: b E N'T ;[ A i.. <br />CONSTRUCTION TYPE: OCCUPANCY'. <br /> <br /> J:~478 L. AI<EWOOI) I)R NE : CONTRACT CITY; .OCCUPANT LOAD'. <br /> AUROr(A I:)R 77~82 ~ ~It]F! COUNTY; NO <br /> <br />MAILING ADDRESS: , SUBDIVISION: <br /> <br /> PHONE~ 478-14',.;,3 : VALUATION= <br /> ~ , ~ , , <br /> <br /> TYPE: ELEI;TRICAL PERMIT OR APPLICATIOH NO-' <br /> <br /> bOIllkAbfOR~ riO. SIJPE.;~VI,SZNS EJ_ECTRICIAN/NUHBER <br /> I.]:CI-~NSE I,! 0 .'i <br /> 8HiTH,~ JAHES .~LLr.~i,I <br /> <br /> PH(]NE~ 678-I450 <br /> <br /> I TE~4 QUANT'I'TY AHOUNT <br /> BRANCH [;IRC[lIT. w~'rH,O, UT SERVICE OR FEEl)ER - 1S'f' C;I:F,'CUCT 1 <br /> ELECFRI~CAL STATE SUR~,HARGE $1.75 <br /> <br /> TOTAL ASSEBSED FEES <br /> I'RE¥IOIJS RECEIPTS $:~6,7,5 <br /> 'HIS RECEIF'T <br /> <br /> : 8~kANCE DUE ,~.. <br /> PAYEE= RECEIPT NO: <br /> R~CEIVE~ ~:~Y~ P8 "TYPE~ CHECK ¢~ <br /> $ THIS IS A VALID PER~IT::I: .:THIS PERH[T EXPIRES 188 DAYS:FEO~ iTS ~SSUE DATE. <br />CONSTRUCTION CEASEG FOR~A~::.~ER~oD: OF .:18~=DAYS~ OR IF CONSTRUCTION FALLS TO ~EET ALL <br />~EGUIREHEHTS OF STATE AND ZOH!HG ORDIHANCES~ THIS <br />SHALL BECDHE HULL AND VOID, : <br /> <br /> R~HARKS: :L C~R FOR <br /> <br /> E,, W['JODLEY~ NARtDN COUNTY BUII._DIN6 OFFIOIAL. / BY . ..................................... ~._ .................... <br /> ~)(lJ,lA~...~) <br /> <br />OFFICE COPY <br /> <br /> <br />