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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 22.5 <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 8 property I own or occupy. <br />I am a registered builder OR the authorized representative <br />of a rrglstered builder, <br /> <br />PIETROK,~ C..ARENCE ; 6~ 66~e~ RESIDENTIAL <br /> <br /> 11481 SNAFF RD SE ~ CONTRACT. CITY; [UGB: j OCCUPANT LOADZ <br /> AUHSVILI,,E 0R 77J25 ~A~ON COUNTY =NO <br /> <br /> ~ SITE NUMBER= <br /> PHONE: 7&?-5364 VALUATION: <br /> <br /> i <br /> <br />TYPE-' ELECTRICAL <br /> <br />C0~'rRACT~R, NO. <br />LI£,ENSE ~'10: <br />PIETI-~OK~ CLARENCE <br /> <br />PERMIT OR APPLICATION NO: 58~51 <br /> <br /> SUPERVISING ELECTRICIAN/NUMBER <br /> <br />PHQHE: 769-5564 <br /> <br /> ITEfl <br />~RAI,ICH CIRCUIT. WITHOUT:,SERVICE :OR FEEDER <br />ELECTRICAL STATE SURgHAR~E : <br /> <br />. 1ST CIRCUIT <br /> <br />QUANTITY AHOUNT <br /> $1.75 <br /> <br /> TOTAL, ASSESSED FEES $36.7',5 <br /> PREVIOUS RECEIPTS $36.7,5 <br /> THIS RECEIPT $0.00 <br /> BAL;~NCE DUE Se,, 00 <br /> <br /> RECEIVED BY: DF' TYPE: RECEIPT NO: <br /> .................................. ~L.~_.,. CHECK ~: 8 <br /> <br /> ~ THIS IS A VALI~ PERHIT ~AYS FRO~ ITS ISSUE ~ATE. iF <br />CQNSTEUCTIOH CEASES FOR A IF CONSTRUCTION FAILS TO ~EET ALL <br />REQUIREMENTS OF STATE LAWS AH~ H~RlON COUNTY BUILDING AN~ ZONING ORglNANCES~ THIS PERMIT <br />SHALL BECOHE NULL AND VOID. : <br /> <br /> RE:MARl(S: 1/CIA <br /> <br /> I)ONALO E. WOODLEY~ MAR~ON COUNTY BUILQING OFFICIAL /BY .;; ................................................. <br /> <br /> OFFICE COPY <br />FORM # MC 15-58 REV. 4/90 <br /> <br /> <br />