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MARION COUNTY BUILDING INSPECTION, <br />COMMUNITY DEVELOPMENT CENTER <br /> <br /> 285 Church Street NE · Room 132 o' Salem, Oregon 97301-3670 <br />Office Hours: 8:00-4:30 · Phone: (503) 588-5147 · 24-HR Inspection Line: (503) 588-7904 <br /> <br />DATE/T[HE <br />TYPE <br />OCCUPANCY <br /> <br /> ELECTRZCAL PERHIT <br />: 84/0[/76 _i3:52 <br />: Resident. addition/alteration <br />: R-3 <br /> <br />PERHIT NO <br />STATUS <br /> <br />TO EXPIRE <br /> <br />96-02159 <br />ISSUED <br />e4/~1/1996 <br />09/28/1996 <br /> <br />WORK DESC <br /> <br />SITE ADDRESS <br /> <br />: A/C CONNECTION I CIR <br /> <br /> 7165 AUMSVILLE HY SE AM <br /> <br />CITY: AUMSVILLE <br /> <br />CROSS STREET : <br /> <br />PARCEL NUMBER : AM <br /> <br />OWNER NAME <br /> <br />APPLICANT <br /> NAME <br /> ADDRESS <br /> <br />PHONE <br /> <br />CONTRACTOR <br />PHONE <br /> <br />ELECTRICIAN <br /> PHONE <br /> <br />SLJF'V ELEC <br /> -PHONE <br /> <br />: FOREST,JIM <br /> <br />: KEIZER ELECTRIC INC <br />: PO BOX 7246 <br /> <br /> SALEM. OR <br />: 37B-B267 <br /> <br />: KEIZER ELECTRIC INC <br />: 378-B267 <br /> <br />: KEIZER ELECTRIC INC <br />: 378-~267 <br /> <br />: ALJETS DOUGLAS F <br />: ALJETS DOUGLAS F <br /> <br />973~3 <br /> <br /> OCCB: 002,535? <br />CONTRACTOR LICENSE: 24-68C <br />SUPERVISOR LICENSE: 2843S <br /> <br />Un.~t~ .... Desc[iption , <br />i "Branch circuits <br />I State surcharge <br />1 Refund <br /> <br />Fee <br /> <br />1,75 <br /> <br /> Assessed fees : 36.75 <br /> Adjustments : .OB <br /> TOtal fees : 36,75 <br /> PAYEE: KEIZER ELECTRIC IHC Total pa%~ents: 36.75 <br /> Balance ~ue : .0~ <br /> <br />· THIS PERMIT IS NON-TRANSFERABLE AND. EXPIRES 188 D~YS FRQH ISSUE D~TE IF #QRK H~S <br /> <br /> FAILS TO HEET ALL REQU[REHENTS OF STATE LAM' C___T_A___X__H__"_OR_PoH <br /> WRITTEN REQUEST, ONE SIX HONTH EXTENSION HAY <br /> <br /> SIGNATURE OF APPLICANT: <br /> <br /> *************************************************************************** <br /> DONDALD E WOODLEY, MARION COUNTY BLJILDINBG OFFICIAL / BY DFREILIN~__~ <br /> <br /> <br />