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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG.' NO, 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97801 <br /> <br /> PHONE 588-5147 <br /> CODE-A-PHONE 4:80 P,M,- 8:00 A.M. // / ~ ~,, <br /> I am performln~ work on aproperty I own or occupy, <br /> lofama reglstereda registeredbuitder,bUilder OR the authorized represen a ire $ GNATURE OF AEPL CA T <br /> <br /> The work will be performed by a registered builder, <br /> Other ....... <br /> I have read and agree to the terms stated on the reverse side of DATE'. <br /> this document, <br /> <br />0ARE: 07/07/$7 TI~E: 2:48:08p <br /> OWNER~ , TAX J. OT: CATEGORY: <br /> 4HiTE, CHARLES R. R <br /> <br /> SITUS ADDRESS: ' CONSTRUCTION TYPE: OCCUPANCY; <br /> <br /> 5775 SHAW HWY SE ............ <br />,AU?~SV;,LLE OR 97325 ~ CONTRACT CITY'· i MGIC: <br /> , F,1C N <br /> <br />OccuPANT LOAD; <br /> <br />~HONE: 364-6429 <br /> <br />WIDTH: <br /> <br />SITE NUMBER: 1841 <br />VALUATION: <br /> <br /> 2W <br /> lRREG. LOT: CORNER; <br /> N N <br /> <br />TYPE: MECHANICAL <br /> <br />CO~ZRACTQR NO_ <br />~' ~Z': ~, CHARLES R. <br />SA~E <br /> <br />PERNIT OR APPLICATION NO: <br /> <br />3055 <br /> <br />>'-~f3N E: 364~6429 <br /> <br /> l T EH <br />DOMESTIC ~40OD STOVE <br />'~(~'f..',;-~AN !CAL ~3ASE FEE <br />FLEILr ZCJRCHARGE ~7ONF,, 2 <br />I~a'~C,*!ANZCAL STA.TE SURCHARGE <br /> <br />PAYEE: NH:T'E, CHARLES R. <br />~ECEiVE0 BY: P8 <br /> <br />~ THIS IS A VALID PERMIT ~ THIS PERMI' <br />CONSTRUCTION CEASES FOR A PERIOD OF <br />RE~UIRE~E~4TS OF STATE LAWS AND MAR] <br />SHALL BECO~4E NULL AND VOID_ <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />SALANCE DUE <br /> <br />QLiANT i' TY A~OUNT <br /> $ ': O. O0 <br /> <br />$20_9L <br /> <br />$20,94. <br /> <br />$000 <br /> <br />INVOZCE NO: 3575 <br />TYPE: CK CHECK ~: 4004 <br /> <br /> ITS IE:4-e~E DATE. IF <br />TION FAILS TO MEET ALL <br /> NG ORDINANCES, 714IS PERMIT <br /> <br />;~EMA. RK.S: MECH 2658 R:~2584 <br />3CNAL0 E, ~OODLEY. iVlARiON <br /> <br />OFFICE COPY <br /> <br /> <br />