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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STJ~EET NE <br /> SALF:M. OREGON 9'7301 <br /> <br /> PHONE 588-5147 <br />COPE-A-PHONE 4:30 P.M. - 8:00 A.M. <br /> <br />I am performing work on a property I own or occupy, <br />I ~¢q ~ registered builder OR { ) the authorized representative <br />of a registered builder, <br />The work wHI be pedormed by a registered builder. <br />Other <br /> <br /> I h,~ve read and 8gree to the terms s~ated on the reverso side of <br /> this docur~erlt <br />BATE: 12/16/87 T II~IE: 8:59:36a <br /> <br />OWNE,: H.NV~4ETT, GARY <br /> <br /> 11278 $IMPC-~ON RD <br />AUMSVILLE <br /> <br />USE OF BUILDING: <br /> <br />OR 97325 <br /> <br />SE <br /> <br />i TXx <br /> <br /> CONSTRUCTION TYPE; <br /> <br /> CONTRACT CITy: UGLY: <br />MARION COUNTY NO <br /> <br />SAME <br /> <br />PHONE: 749-1498 <br /> <br />TYPE: MECHANICAL <br /> <br /> BLOCK: SECTION: <br /> 2O <br /> <br />CEPTH: AREA: 20.0000 :UN,TS: AC <br /> PERMIT OR APPLICATION NO: <br /> <br />; CATEGORY: R <br /> <br />~ OCCUPANCY: <br />:OCCUPANT LOAD; <br /> <br />SITE NUMBER': 194~ <br />VALUATIONs <br /> <br />TOWNSH P; I RANGE; r ZONE; <br />: 8S I 1N , EFU <br /> <br /> i IRREG, LOT: NO <br /> <br />CONTRACTOR, NO. 52028 <br />NATE BAKER CONST, <br />43415 KINGSTON/LYONS DRIVE <br />STAYTON 97383 <br />PHONE: 859-2308 <br /> <br /> ITEM <br />COME~TIC l,~D STOVE <br />MECHANICAL BASE FEE <br />FLEET SURCHArgE -ZONE 3 <br />MECHANICAL STATE SURCHARGE <br /> <br />QUANTITY <br /> 1 <br /> <br />594? <br /> <br />TOTAL AEE, ES~EI3, FEES <br />PREVIOUS,: REOEI PTS <br />THIS:~ RECEIPT <br /> <br /> BAEANCE DUE ',, , <br /> <br />AMOUNT <br /> $?.50 <br /> $10.00 <br /> ~3.84 <br /> 0.88 <br /> <br />$22,22 <br /> $0.00 <br />$22.22 <br /> <br />$0.00 <br /> <br />PAYEE: MATE BAKER CONST. ,,' : ?: :. ,::; ; :RECEIPT NO; 6524 <br />RECEIVED BY: c] ................. ~ ......... ' ,TYPE'. CK,;CHECK ~.- 0 <br /> <br />~ TH[,$ I$ A VALID PERMIT ~ TI-I~$ PERI'lIT ~EXP[RE~:::188..DA¥S ,~/[T$ ISSUE DATE. IF <br />CON~I'kI..ICTIQN CEASES FOR A PEI~IOD 'IF;i~T. ION FAII..~ TO MEE'T ALL <br />RtT:QUIR~ OF STATE LA~ ,/CID IvlA~toN :~ :I~.[LD'rN6 ,~lD ZONIN~ ORDINANCES, THIS PE~IT <br />SHALL BECOME NULL AND VOID. <br /> <br />REHARK~: ~ RAtS,,¢91 <br />DONALD E. NOODLEY, IvLARION COUNTY BUILDING 0~FicZAL / BY ..................... <br /> <br />"O,M ,, Mp ~.~ ~v e/~7 OFFICE COPY <br /> <br /> <br />