Laserfiche WebLink
MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO, 225 <br />220 HIGH STREET NE <br /> SALEM, OF~EGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PI~ONE: 588-7904 <br /> <br /> I am performJn9 WOrk on a property ~ own or o¢oupy. <br /> I am 8 reg~$teredbu,lderOR( ) the authorized representative <br /> of a regmtered builder. <br /> tho work will be performed by a registered budder. <br /> Other <br /> I have read and agree to the reft'ns stated on tho reverse side of <br /> this document. <br /> <br /> DA'rE: 01/08/91 'I'i~E~ 15:47:21 <br />OWNER' <br /> ,.~(;H i E1VI/U~, JOE <br /> <br />SITUS ADDRESS: <br /> <br />SIGNATURE OF APPLICANT <br /> <br /> DATE: <br /> <br /> T&~' LOT: <br /> <br /> 2ONSTRUCTION TYPE <br /> <br /> 98;28 ,~,'I'AY'I-ON RD ,SE <br />AUf4SVi LLE OR 9'l~.25 <br /> <br />USE OF BUILDING: <br /> <br />COUNTY NO <br /> <br />MAILING ADDRESS <br /> <br />SUBDIVISION <br /> <br />PHf.~E: 769-2925 <br /> 0 <br /> <br />95 <br /> <br />AC <br /> <br />CATEGOR~ <br /> RESi DENT <br /> <br />DCCUPANC <br /> <br />OCCUPANt LOAD: <br /> <br />'SITE NLIIfSER: 123 <br />VALUA'r l ON: <br /> <br /> 1IAI EPIJ <br /> <br /> RREG LOT. CORNER; <br /> NO <br /> NO <br /> <br />TYPE: MECHANICAL PER~iT OR APPLICATION NO: <br /> <br />29892 <br /> <br />CON'rnAc'roR, NO. 498 <br />C.J. HANSEN C~. <br />PO BOX ?397 <br />'SALEN, OREGON 97303 <br />PHONE: 362-3643 <br /> <br />HEAT PUmP <br />AIR HANDL UNiT 1'O 10000 CU Fl' <br />MECHANICAL BASE FEE <br />FLEET SURCHARGE -ZONE 3 <br />MECHANICAL 8'rATE SURCHARGE <br /> <br />Q)UANTI'fY AMOUNT <br />1 $8.00 <br />1 $4.50 <br /> <br /> $3.84 <br /> 1.03 <br /> <br />'tOTAL ASS~ED BEES <br />PRE¥IOUS RECEIPTS <br />THiS RECEIPT <br /> <br />$25.37 <br /> ~0.00 <br />$25.3'I <br /> <br />BALANCE f.~JE $0.00 <br /> <br /> PAYEE: C.J. HANSEN O0. RECEIPT NO: 31366 <br /> RECEIVED BY: ON2 TYPE: CK CHECK ~: 15842 <br /> <br />~ THIS iS A VALID P/I~liT ~ THiS PER'lIT EXPIRE~ I'80OAY~FR(~ ITS i~E DATE. if <br />~ST~CTI~ C~ FOR A:PERiOD OF 180 ~, OR IF~CT[~ FAI~ TO ~EET ALL <br />RE~IR~TS OF STATE ~ ~O ~R[~ ~NTY BUILDING ~O Z~JN~ ORDIN~C~, THIS <br />~ALL B~E NULL ~D <br /> <br />RP3'&ARKS: HP/AHU R~5678 <br /> <br />0ONALD E. NOODLE¥, t4ARiON COUNI'Y BUiLDiNG OFFiCiAL / BY <br /> <br />FORM # MC 15.56 REV. 4/~O OFFICE COPY <br /> <br /> <br />