Laserfiche WebLink
MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STRE~TILNE <br /> SALEM, ORE~©N 97~01 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am performing work on a property I own or occupy, <br />I am ~ registered builder OR ) the authorized representative <br />of a registered builder. <br />The work will be performed by a registered buifder, <br />Other. <br /> <br /> I have read and agree to the terms stated on the reverse side of <br /> th~s document, <br /> <br />BATE.' 12/17/90 'rlrr4E: 14..19:0:3 <br />OWNER. <br /> GREEN, JOHN <br />SITUS ADDRESS: <br /> <br />40580-000 <br /> <br /> 15056 PARK AVENUE NE <br />AURORA OR 9?002 <br /> <br /> CONTRACT ClT'f JGE <br />~J. BoRA NO <br /> <br /> 3674 PACIFlC HiGHWAY <br /> HUBBARD, OREGON 9'1032 <br /> PHONE: 981-1175 SITE NUFr~ER: <br /> VALUATION: <br /> <br />LOT; BLOCK SECTION: TOWNSHIP' RANGE <br /> <br />WIDTH. I)E PTN AREA UNITS RRE~ LOT; <br /> 130 150 19800. ~ NO <br /> <br />CATEGORY <br /> RESIDENTIAL <br /> <br />OCCUPANCY <br /> <br />OCCUPANT LOAD; <br /> <br /> 1041 <br /> <br /> ZONE MAP. <br /> <br />CORNER <br /> NO <br /> <br />I'YPE.~ PLUr~ 1NG <br /> <br />CONTRACTOR, NO. 28838 <br />'f'.G.NiCHOL PLUt, I~ING, INC <br />P.O.BOX 166 <br />AUMSViLLE, OR 9?325 <br />PHONE[: 749-2071 <br /> <br /> ! TF.~I <br />RE~iDEN'FIAL FIXTURE, NEq~ CONST. <br />PLU/V~ING B~E FEE <br />FLEEr EMRCHARGE -ZONE 6 <br />PLUC4~iNG STATE SURCHARGE <br /> <br />PER,lIT OR APPLICATION NO~ 9029366 <br /> <br />C~JANTiTY <br /> 12 <br /> <br /> TOTAL A,%~E~ED FEF.~ <br /> pREY IOU~ RETC£1PTS <br /> ..... P <br /> <br /> PAYEE: '['.G.NiCHOL PLUMING, iNC ~ ~ : ~ INVOiC~ NO: <br /> BY, m2 ............................ <br />* THIS 18 NOT A PEBIT, :THI~'AP~iI~ ~T ~ TH~ A ~i~ ~ ~E~ THE <br />EOLL~IN6 ~Sf 8E ~T~. [.T J~ THE ~181LITY OF THE AP~I~T TO ~ THAT <br />ALL N~ ZN~TZ~ H~ BE~ P~vI~D. <br /> <br /> P~ REVIEW: BY ~I'E CiTY JURISDiC')'i~: BY DATE <br /> ................................ ~ ,..~, ~,...~ .............. . ............................................... <br /> <br /> R~R~: 12 EiX ~7'18 <br /> <br /> $1o8.oa <br /> $20.00 <br /> <br /> $0.o0 <br /> $135.68 <br /> <br /> $8.~o <br /> <br />31031 <br />4526 <br /> <br /> OFFICE COPY <br />FORM # MC 15.56 REV. 4/90 <br /> <br /> <br />