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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 a registered builder ORthe authorized representative <br />of a registered builder. <br /> <br />Other <br /> <br /> ,5750 F]:t,.BERI CREEl( LANE SE -ES'~¥~,~dfcifYi !OOCUPANT LOAD. <br /> AUNSYZLLE O" 9732t~ ~ARIt')N COUNTY ~0 <br /> <br />MAILIN~ ADDRESS: SUBDIVISION; <br /> <br /> 234 1,18., CENTER ST. I <br /> SOBLI~ZTY 77~85 ] SITE NU~BER~ <br /> PHONE= 7&~75e& I V~LUATZOH~ <br /> <br />LOT', BLOCK'. SECTION: ~ TOWN~HIP: ~ RANGE'. ~E~ ~' ~ <br /> <br />TYPE: ELECTRICAL <br /> <br />CONTR~E'TOR~ HO. <br />LICENSE HO: <br />KII_MARTIF!~ PAT <br />234 NO. CENTER ST. <br />.5'UBL l M ',['l"y 97~85 <br />PHONE: 767-7596 <br /> <br /> ITEM <br />SERVICE/FEEDER LES8 TN~N 2~O:~'MPS <br />F'U~P OR IRRIGATION CIRCLE <br /> <br />PERNIT OR APPLICATION NO: 6~287 <br /> <br /> SUPERVISING ELECTRIC]:AN/NUMBER <br /> <br />QUAIqTITY <br /> <br />AMOUNT <br /> $50.00 <br /> $40.00 <br /> $4~50 <br /> <br /> $94.50 <br /> $94.50 <br /> $0.00 <br /> <br /> $0.00 <br /> <br /> ELECTRICAL STATE SURCHARGE <br /> :,,' TOTAL A:SSE~sED FEES <br /> :: : ::: PREVI'OU$ RECEI:P, TS <br /> ,-.THIO :RECE:IPT <br /> <br /> PAYEF: : RECEIPT NO: 0 <br /> RECEIVED BY." DF ;: :': :TYPE= El'lEEK <br /> .................................. <br />~[~[~g~ ~[AS[~ FOR PERIOD OF 188 OAYO~ OR IF CONSTRUCTION FAILS TO <br />~UUZ~b~[N/~ UP SIATE'LA~S :~Ng::HAEION COUNTY ~UIL~IN~ AN~ ZONING OR~NANCE3~ TH~S PERMIT <br />SHALL 9COOKE NULL AN~ ,VOI:~. <br /> <br /> RF,~RK,~. ~ FEEDER TO POE:E ~L~6~ ~ PU~P <br /> <br /> DONALD E. WOOI)L, EY~ H~R~ON COUN'TY ~U~L~ZN[; OFF~CZAL / 9Y <br /> <br />OFFICE COPY <br /> <br /> <br />