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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 or occupy, <br />I am a registered builder OR the authorized represen a ire B~(~NATURE OF APPLICANT: <br /> of a registered builder. <br />The work will be pedormed by a registered builder. <br />Other <br />I have read and agree to the terms stated on the reverse side of CATE; <br />this document, <br /> <br />ol~A~rr~: 03/14/88 TIME: ~:3~a ....... +AX LO~; ! CA+6OOR¥; <br />s~us AODn~NELl~ VERST ,, CONSTRUCTION TYPE: i OCCUPANCY: ~ESZDENTZAL, <br /> <br />20342 OL~TEAD RD NE J I ~ <br />~RG~A 0 ' ~ ~ <br />USE OF 8UILOING: ~RION ~UNTY NO ::.o o~ e[~oo~s. <br /> <br /> SAME <br /> <br /> PHONE: 678-5;845 <br />LOT: BLOCK; <br /> <br /> DEPTH; <br /> <br /> AREA: i UNITS; <br /> <br />..................... ~ ....... ;::7''-~''~''' '''''~ ' ~m~ ,,~ <br /> <br />SITE NUI'~ER: 3884 <br /> <br /> I ' <br /> I IRREG, LOT; !CORNEN: <br /> <br />TYPE: MECHANICAL <br /> <br />CONTRACTOR, NO. <br />G IANELLA, VER, HON T <br />SANE <br /> <br />PHONE: 678-5845 <br /> <br />PERMIT OR APPLICATION NO: ?208 <br /> <br /> ITEM <br />DOMESTIC WOOD STOVE <br />MECHANICAL BASE FEE <br />FLEET SURCHARGE -ZONE 6 <br />MECHANICAL STATE SURCHARGE <br /> <br />PAYEE: GIANELLA, VERMONT <br />RECEIVED BY= OM <br /> <br />c~'rRUCTION CE~ES FOR A PERIOD: OF 180.1 <br />REQXJIRENE~TS OF STATE LAk~ANDMAR] <br />SHALL BECO~IE NULL AND VOID~ <br /> <br />QUANT2TY AMOUNT <br /> q $?.50 <br /> $~0-00 <br /> $?,68 <br /> $0.98 <br /> <br />REMARKS: EXISTING NS R~93L9 <br />0ONALD E. NOODLEY, MARION COUNTY EuILDZNG:0FFZC~iAL / By <br /> <br /> PREVIOUS: BECE[,PTS $0.00 <br /> $~6.06 <br /> ,,: THI'S 'REGEIPT, <br /> <br /> ,:; '" ': ~CEIPT NO 7837 <br />, : :~,', : :,;,;,~; :,;;:,,:.:'.::~PE:; hCA',, ;,':CHECK ~; 0 <br /> <br /> I;TS I~E DATE. IF <br /> '.~ FAI~ TO ~E~ ALL <br /> Z~ING OEDIN~C~. ~IS P~IT <br /> <br />,o,~. MC ~s-,~ ,EV e~a7 OFFICE COPY <br /> <br /> <br />