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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLOC, NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 888-8147' 8:00- 4:80 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> lamareglsteredbuilderOR{ )theauthorlzedrepresentative <br /> of a registered builder, <br /> <br />DATE.' 1.J:['ZI94 TTNE: I0'-'30:28 <br />, ~:[L~AR'f IN, PAT ;75901;86 ,~ESIDENTIAL <br />81TUS ~bDl~S~ ......................................................... I CONSTRUCTION TYPE; OCCUPANCY' <br /> <br /> ?50 FIL.~ERT CREEK LANE . SE h~-~;&;~,~ ..... ~'~i~. <br /> AUHBVIL. LE OR 97325 H~'IB'~ ~LINTY NO ' <br /> <br /> 234 NO. CEllTER ST. <br /> SUBLIMITY ~7385 SITE NU~ER~ <br /> PHONE: 7&?--7596 j VgLU~TION~ <br /> <br /> c6~: ........... ~ ~L~: ............... ~fi~iEh' ......... ~i'~7' ' RAh~X ............. <br /> I 1.4 80 2W AR <br /> <br />TYPE: ELECTRICAL <br /> <br />CDN'¥RACTDR~ NO~ <br />LICENSE NO: <br />KILHARTIN. PAT <br />234 biO. CENTER ST. <br />SUBLIMITY 97385 <br />PHONE: 769-7596 <br /> <br />PERHIT OR APPLICATION NO: 9868287 <br /> <br /> 8UPERVISING ELECTRICIAN/NUMBER <br /> <br /> ITEH <br />SERVICE/FEEDER LESS THAN 2~ A~PS <br />F'U~P OR IRRIGA'f~OIq CIRCLE <br />EL.£C'rRICAL STATE SURCHARGE <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS ~ECEIPT <br /> <br />BALANCE' DUE <br /> <br />QUANTITY A~OUN'r <br /> <br /> 1 $40,,00 <br /> $4~50 <br /> <br />PAYEE: RECEIPT NO: <br /> <br />$94.50 <br /> <br /> RECEIVED BY: js .................................... TYPE: CHECK ~: 0 <br /> <br /> · THIS IS NOT A PERMIT. THIS' APPLICATION MUST GO THROUGH A REVIEW PROCESS WHERE THE <br />FOLLOWING HUST BE COHPLETEB. ,IT TS THE RESPONSIBILI,TY OF THE APPLICANT TO ASSURE THAT <br />ALL NECESSARY INFORMATION HAS BEEN PROVIDED. " <br /> <br /> PL~I,I REVIEW= BY ' 9ATE , CiTY JURZS9ICTZON= ~Y ~1'E <br /> REMARKS,, J F'EE~ER TO POLE ~L~6, ~ PUMP , <br /> <br /> OFFICE COPY <br />FORM # MC 15-56 RE~/. 4./80 <br /> <br /> <br />