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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 sm performin9 work on aproperty I own or occury. <br />l am a registered builder OR ( )theauthorlzedrepresentative <br />of a registered builder. <br />The work will be performed by a registered builder. <br />Other_ <br /> <br />DATE: 09/02/8'7 T I~4E: · :11 ;,.5 :~..- 5.8a <br />OWNER; i TAX LOT: QATEGORY'. <br /> LUCAS, REX DIAZ-RENTER ,: R <br /> i coNsTRUcTioN T~P~; o~COPANCY; <br />SITUS <br /> <br /> 825 N 4TH OGGUPANT LOAD: <br /> AU~V~ LLE OR 9?325 <br /> <br />USE OF BUILOlNG; ?0 OF BEDROOM8 <br /> <br />1010 N 4TH <br />AUMSVILLE, OR <br />PHONE; ?~9--1414 <br /> <br />LOT: : BLOCK: <br /> <br />97a~.5 ~ <br /> i SITE NUMBER: 2393 <br /> : VALUATION: <br /> <br /> AREA: I UNITS: ; IRREG. LOT; i CORNER: <br /> I ~ <br /> NO ~ <br /> <br />TYPE: MECHANICAL PERMIT OR APPLICATION NO: 4125 <br /> <br />CGNT~ACTOR, NO_ <br />LUCAS, REX DIAZ-RENTER <br />i010 N 4TH <br />AUMSVILLE, OR 9?325 <br />,::>HONE; 749-1414 <br /> <br /> ITEM <br />OOf.4ESTIC WOOD STOVE <br />~IECHANICAL BASE FEE <br />FLEET SURCHARGE ~ZONE 3 <br />~IECHANICAL STATE SURCHARGE <br /> <br />PAYEE: LUCAS, REX <br /> <br />QUANTITY AMOUNT <br /> ~ $7.50 <br /> $~0..o0 <br /> $3,84 <br /> SO_SS <br /> <br /> i ~O~AL - ASSESSE~ ;FEES <br /> '"~RE¥~OUS:;RECEZPTS' <br /> <br />BIAZ-RENTER ~NVOICE NO: <br /> <br />$22_22 <br /> $0,00 <br />$22.22 <br /> <br />$0,00 <br /> <br />~ECE!VEO 9Yt JB ,: ,, , TY~E:;IN: CHECK ;~: <br />~: TH]',S ~S A VALID PERr4~'T ~ ~S ~TS ~E ~TE, <br />~ST~CTZ~ C~ FOR A ~RZOB OF 180 ~:~ST~CTZ~~ FAZ~ TO ~ ALL <br />RE~ZR~TS OF STATE ~,~B ~RZ~ ~EB~N~D Z~NG ORD~C~. ~ZS PE~ZT <br />~ALL BEdE NULL ~ ~D. , ~ , <br /> <br />REMARKS: W.S. ,~: <br /> <br />~o.~ ~ ~o ~ ~-~e .sv ~/a~ OF FI CE COPY <br /> <br /> <br />