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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PitON E '~88-5147 <br /> CODE-A-RHONE 4:30 P.M. - 8:00 A.M. <br /> <br />DATE: 06/23/87 TIME: ; :25;28p <br /> <br /> !lASTINGS, GERALD <br /> <br /> 10252 LEVER~AN SE <br />AUJ~SVILLE OR 97325 <br /> <br />SIGNATURE OF APPLICANT: <br /> DATE: <br /> <br /> TAX LOT: <br /> CONSTRUCTION TYPE: <br /> CONTRACT CITY'. <br /> <br />5N <br /> <br />CATEGORY'. <br /> <br />OCCUPANCY: <br /> <br />OCCUPANT LOAD; <br /> <br /> SAME <br /> PHONE_, '749~,1369 <br /> <br />LOT: BLOCK: SECTIONI <br />WIDTH: DEPTH: AREA: <br /> <br />CONTRACTOR, NO, <br />HASTINGS, GERAL0 <br />SP~E <br /> <br />PHGNE: 749-'1369 <br /> <br /> ITEM <br />8LIILDING FEE <br />FLEET SURCHARGE -Z¢~E 3 <br />STATE SDRCHARGE <br /> <br /> TOWNSHIPr <br /> <br /> 31 8S <br />2. 00000uNITs: AC <br /> <br /> ~ $0, O0 <br />RANGE: ZONE: MAP: <br /> iN AR <br />IR~EG ~OT: CORNER: <br /> N N <br /> <br />APPLICAT <br /> <br /> ARCHITECT/ENGINEER, NO, <br /> <br />PHONE: <br /> <br />TOTAL. ASSE~ED FEES <br />PREV£OUS RECEIPTS <br />THIS RECEIPT <br /> <br />BALANCE DUE <br /> <br />OUANTITY <br /> <br />AMOUNT <br /> $10,00 <br /> <br /> $}4.24 <br /> $0_oc <br /> <br /> $0_80 <br /> <br />c>AYEE: INVOICE NO: <br />RECEIVED BY: P~ ' TYPE; CHECK ~: <br /> <br />* THIS IS A VALID PERf4IT * THIS PEI:~I~ EXPIRES 180 DAYS FROH ITS ISSUE DATE. IF <br />CONSTRUCTION CE, AS. ES FOR A PERIOD OF_ 180 DAYS, OR ~CONSTRUCTION FAILS TO ~EE% ALL <br />REQUIREMENTS OF STATE LA~D~R~ COUNTY BUILDINGAND ZONING ORDINANCES, THIS PERMIT <br />SHALL BECOME NULL AND VOID. <br /> <br />OFFICE COPY <br /> <br /> <br />