Laserfiche WebLink
MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97'301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br /> 24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> I am a registered builder OR the authorized represen a ye glGNATURE OF APPLICA <br /> Of a reglstered builder, <br />( ) The work wilt be per¢ormed by a registered builder, <br />( ) Other ......... <br />( ) I I~ave read and agree to the terms stated on the reverse side of gATE; <br /> thio document, <br /> <br />~ OWNEF[~ TAX LOT: ' CATEGORY: <br /> F E R Y ~ I.::H ,"i R/_. ]; K :"i I F::'c",~ D 1'": N '"'l 1 A ~._ <br /> <br /> :[~618 S'T~YTDH RD c~E CONTRACT CfTY: UGB; OCCUPANY LOADz <br /> ~U ~.V.Lb, 0R !H~RZON COUNTY <br /> <br /> MA[MNG ABORESS; : SUBDIVISION; <br />~ J ~ L ~ NO <br /> <br />TYPE: ELECTRICAL <br /> <br />FX'Ji, I'f'R AC f'0R ,~ N0,, ~?&4 <br />LICIENSE NO: <br /> <br />1¢764 FI:L;:[ C~'eek Rd <br /> <br />PH' 4;]= 749'-297:r. <br /> <br /> ITEM <br />SERVICE/FEE'DER LESS THAN 28~ AMPS <br />ELEC'f'RIC~L STATE ~oUI: .... CHaRgE <br /> <br />PERMIT OR APPLICATION NO.- 575~? <br /> <br /> SUI:'Ei:~V]:SIN8 t::,l..l~C ~ hTC].AI /NL M],.t;,,:, ,~ <br /> <br />TOTA:L ASSESSED FEES <br /> <br />(DUANTI'FY AMOUNT <br /> <br /> ,i : PREVIOUS RECEIPT~ <br /> : THIS RECEIPT $].0D;,, <br /> <br />CEASES'-- - - ---~ ~---------~..--*-----..,,~. ~.~ ~o~u~ u.~- Z~FOR ~ PERIOD OFiee DAYS~:~OR iF COHSTRUCTION FALLS TO MEET ALL . <br />~¢,~[I[.~):)L[.:y,~ ,A;,i~EN COUN;I'y;BU]LD] ~G OFFIC:.AL / BY <br /> <br />FORM ~ MC 15,56 REV. 4/30 OFFICE COPY <br /> <br /> <br />