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MARION COUNTY BUILDING iNSPECTION <br />SENATOR BLDG. NO, 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97'301 <br /> <br /> PHONE: 888-5147 8:00 - 4:30 <br /> 24 HOUR CODE-A-PHONE: 588-7904 ~/~ <br />I am a registered builder OR the au hot zed erresen ave S GNATURE OF APPL <br />The work will be ,erformed by ~ registered builder. (.../ -- // '~' / <br />Other <br />I have read and agree to the terms'stated on the reverse s de o DATE <br /> <br />l....... , ' ...... ; i CATEGORY: <br /> IAUTFE!:;'r, RUSSELL "i RESIDENTIAL <br /> <br /> :1.1;{Z1F'AF~I;O RD NE ;CONTRACT CITY'. ~UGB; ~u~ANT'LOAO: <br /> AURORA OR ~7ee2 MARION COUNTY ~ NO ¢ <br /> <br />~ SITE NUMBER: 94-~2553 <br />~ PHONE~ 678--216~ VAL. UATION: <br />~LOT: ~LOCK; S~c~ibA~ ;~m~ i"E%R6B.. ~-~ [~ <br />; ~ ~ m ~ ; ' <br /> ~o 4.S ~ - ~. LEU- 4 <br /> W DTH; DEPTH: ~ AREA; ~ UNITS: j IRREg. LOT: CORNER: <br /> j 2.7~ AC qO NO <br /> <br />TYPE: ELECTRICAL <br /> <br />COI,ITRAC'IOR ~ NO. <br />I..I CENSE; NO. <br />TAU fFE'ST, ROSSELL <br /> <br />PHONE: 678-2t69 <br /> <br />PERNIT OR APPLICATION NO: 572?6 <br /> <br /> SUPERVISING ELECTRICIAN/NUMBER <br /> <br /> ITEM <br />BRANCH CIRCUII'~ WIt'HOIj'F SERVICE OR FEEDER - EACH ADDITIONAL <br />ELEOI'RICAL STATE SURCHARGE <br /> <br /> TOTAL ASSESSED FEES <br /> F'F:E¥ 181JS RECEIPTS <br /> <br />QUAI,IT Z, T¥ AMOUNT <br /> ., !Ii 1 ~ ,, 00 <br /> SA. 50 <br /> <br />$10.50 <br /> $~. 00 <br /> <br /> SA. 00 <br /> PAYEE:'. TAUI'FEST, RUSSELL:. ': : :' :; ; ~ :: ' RECEIPT IqO: 61878 <br /> ~:~E:CF:J:VED BY: LD <br /> :;:TYPE:; [;K CHECK ,~: 2]?24 <br /> <br />CONSTRUCTION CEASES FOR A OR'IF CONSTRUCTION FAILS TO NEET ALL <br />REOUIREHENTS OF STATE LABS;:'AN~::':H~RION COUNTY SUItiNG AND ZONING ORDINANCES, THIS PERHtT <br />SHALL BECOHE NULL AND VOID. ' ::: <br /> <br />FORM # MD t§.~ REV, 4/90 OF FICE COPY <br /> <br /> <br />