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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 am Performing work on & property I ow~ or oco~oY, - ...... <br />I am a registered builder OR the authorized representative SIGNATURE OF F~LIL~N/; <br />of a registered builder. <br />The work Will be performed by 8 registered builder, <br />Other <br />I h~ve read and agree to the terms stated on the reverse side of DATE; <br />th{s document. <br /> <br /> DORAN~ JI~ iRESIDENTIAL <br /> ~ETORtT OR ?7342-- MARION COUbTY I NO <br /> <br />MAI~.ING ADDRESS'. ~ SUBDIVISION; <br /> <br /> ~7~5 E LINCOLN <br /> WOODBURIq% OR, 97871 ~ SiTE NU~BER= ~4~17~B <br /> PNONE: ~82-~221 ~ VALUATION: <br /> <br />TYPE: ELECTRICAL <br /> <br />CON'fRACTOE~ NO,, <br />LICENSE NO: <br />BORAN~ JIM <br />1765 E LINCOLN <br />WOODB~RN~ OR V7071 <br />PHONE. 782-7221 <br /> <br /> I?E'H <br />SERVICE/FEEDER LES8 THAN 28~ A~P$ <br />ELECTRICAL STATE SURCHARGE <br /> <br />PERHIT OR'APPLICATION N0: 5474? <br /> <br /> SUPERVISING ELECTRICIAN/NUMBER <br /> <br />TOTALASSESSE~ FEES <br />PREVIOUS:RECEIPTS <br /> <br />QUANTITY AMOUNT <br /> 1 $50.00 <br /> $2..50 <br /> <br />$52.50 <br /> $0.00 <br />$52.50 <br /> <br /> PAYEE: ~ORA~ JIM RECEIPT NO: 57203 <br /> RECEIVE~ BY. CL. , T~PE: CK CHECK ~: ~4~2 <br /> <br />~ THiS IS A VALID FROM ITc ISSUE DATE. IF <br />CONSTRUCTION CEASES FORA FAILS TO MEET ALL <br />REgU[REHEHTS SF STATE ~HD ZONING ORDINAHCES, THIS PERMIT <br />SHALL ~ECOHE NULL AHD <br /> <br /> REMARKS~ RENE~ ELEC PEE~¥ # 4610~ FOR 8VC CHG FROM ~OODSNED TO HOUGELOCAT[ON <br /> <br /> DON~[,B E~ gOOD[.EY~ MASI:ON C~UNT¥ BUILDING OFFICIAL / BY <br /> <br />REV. 4/9o OF FI CE COPY <br /> <br /> <br />