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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO, 225 <br />220 HiGH STREET NE <br /> SALEM, OREGON 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 a property I own (Dr Occupy. <br />l am s registered builder OR ( )theauthor+zedrepresentative <br />of a registered builder, <br />The work will be performed by a registered builder, <br />Qthec <br /> <br /> DATE: 06/23/87 TIME; 3;41 <br /> <br />OWNER: ~3AN©ERS, JC, E <br /> <br />SIGNATURE OF APPLICANT; <br /> DATE: <br /> <br />TAX LOT: <br /> <br /> 695 ~A!N ST <br />AUMSVILLE <br /> <br />USE OF BUILDING: <br /> <br />OR 97325 <br /> <br />CONSTRUCTION TYPE: <br />, CONTRACT CITY: <br /> <br />MAILING ADDRESS: <br /> <br />SUBDIVISION: <br /> <br />N <br /> <br /> SITE NUMBER: <br /> VALUAT I ON: <br /> <br />RANGE: ZONe; <br />IRREG, LOT: N CORNER: <br /> <br />CATEGORY; 9 <br />OCCUPANCYZ <br /> <br />OCCUPANT LOAD: <br /> <br /> N0 OF BEDROOMS: <br /> <br />1741 <br /> <br />MAP: <br /> <br />TYPE:MECHANICAL PERMIT OR APPLICATION NO; <br /> <br />2822 <br /> <br />CONTRACTOR, NO. 3944 <br />JET HEATING <br />:'732 SALEM INDUSTRIAL OR NE <br />SALEM, OR 9?303 <br />PHONE: 383-2334 <br /> <br /> iTEM <br />FORC AIR FURN OVER 100000 BTU <br />MECHANICAL BASE FEE <br />FLEET SURCHARGE -'ZONE 3 <br />~IECRANICAL STATE SURCHAF"GE <br /> <br />QUANTITY AMCLiNT <br /> <br /> $3,84 <br /> $0.79 <br /> <br />TOTAL A,~SBSSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />$22 _ 04 <br /> $0.00 <br />$22. O,: <br /> <br />BALANCE 0UE $0. :~ <br /> <br />PAYEE: JET HEATING iNC. INVOICE ENO: 3334 <br />RECEIVED BY: c1 ................................. TYPE: iN CHECK ~: O <br /> <br />* THIS IS A VALID PERMIT ~ THIS PERNIT'EXPIRFA, 180 DAYS FRON ITS ISSUE DATE. IF <br />OONS~¢TION OEASE~ FOR A PERIOD OF 180 DAYS, OR IF,CONSTRUCTION FAILS TO MEET ALL <br />REQUZREMENTS OF STATE LAWS AND I~ARION CC~JNTY 8UtLD.ING AND ZONING ORDINANOES, THIS PE~41T <br />SHALL 8ECOM£ NULL AND VOID. <br /> <br />REMARKS: FURN _~_._ <br />DONALD E. NCODLEY_ MARION COUNTY BUILDING OFFICIAL /'BY ......................... <br /> <br />OFFICE COPY <br /> <br /> <br />