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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH `STREET NE <br /> SALEM, oREG~ON 97301 <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONE 4:30 P,M, - 8:00 A-M. <br /> <br />I am performing work on ~ property I own or occupy. <br />I am a registered builder OR the authorized representative <br /> of a registered builder. <br />The work will be pedormed by a registered builder, <br />Other <br /> <br />BATE: 08,/19/87 TI~E: 4:36:57p <br /> FmHA <br /> <br />925 5TH ,ST <br />AUMBVI LLE OR 97325 <br /> ~d~VJ~LE L.....NO <br />USE OF OUILOING: <br /> <br />TAX LOW; i CATEGORYZ <br /> ~ COMMERICAL <br /> OCCUPANCY: <br /> <br />CONTRACT C~TY; i UGB; i OCCUPANT LOAC; <br /> <br />1655 25TH ST SE <br />SALEM, OREGON <br />PHONE: 399-5751 <br /> <br />LOT: BLOCK: <br /> <br /> SITE NUMBER: 226'1 <br /> VALUATION: <br /> <br />AREA: ,UNITB: I IRREG. LOT: CORNER: <br /> ~ NO [ NO <br /> <br />TYPE: MECHANICAL PERMIT OR APPLICATION NO: 3868 <br /> <br />CONTRACTOR, NO. 9891 <br />OREGON HOUSING & AS.SOC. <br />1395 LIBERTY ROAD SE <br />SALFJ~, OREGON 97302 <br />PHONEt 585-6193 <br /> <br /> ITEM QUANTITY <br />DOMESTIC WOOD STOVE 1 <br />MECHANICAL BASE FEE <br />FLEET SURCHARGE -ZONE 3 <br />MECHANICAL STATE E~JRCHARGE <br />*ORAL .~E?~D :i,FEES <br />PREV~OUSRECEIPTS <br />THIS RECEIPT <br /> <br /> BALANCE. BUE <br /> <br />AMOUNT <br /> $?.50 <br /> $10.00 <br /> $3,84 <br /> $0.88 <br /> <br />$22.22 <br /> $o,oo <br />$22.22 <br /> <br />$0,00 <br /> <br />PAYEE: OREGON HOUSING & ~C. SEE~ICES ':INVOICE NOt 4424 <br />RECEIVED BY: c3 ..... TYPE:.: IN.!CHECK'~: 0 <br /> <br />* THIS IS A VALID PERMIT ~ THIS ipERMZT~,,~Zp, ES I:80:~DAYS :FROM ITS [S....~JE DATE. IF <br />CONSTRUCTION CF_A~ FOR A ;PERIOD OF:IB0;DAYS:;'OR'~F:,~TION FAIL~ TO MEET ALL <br />RE(~JIRI~BNq'S OF STATE LAMS,AND MA~I$ COUNTY. 8~IEDI:N~AND ZONING ORDINANCES, THIS ~mI~NIIT <br />SHALL BECOME NULL AND VOID. ~ ~ i <br /> <br />REMARK`S: EXISTING ~ /~ ~ <br />DONALD E. WOOBLEY, MARION COUNTY BU~LBING OFFiCiAL /..B!~ ~ ...... ~ .............. <br /> <br />FORM '~ MC 15-~6 REV 6/.7 OFFICE COPY <br /> <br /> <br />