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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 <br /> 4;30 P,M,, - 8:00 A,,M J~/ <br /> <br />The work will be performed by a registered builder <br />Other <br /> <br />this do~-ument <br />DATE; 04/28/88 TTME~. 10: 12: 50a <br /> JOHNSON, EARL <br />SITUS ADDRESS <br /> <br />TAX LOT <br /> <br />CONSTRUCTION TYPE <br /> <br />CATEGORt <br /> <br />OCCUPANCY <br /> <br />RESIDENTIAL <br /> <br /> 8754 MILL CREEK RD <br />ADHSVILLE, OREGON <br /> <br />OR 97325 <br /> <br />SE <br /> <br />CONTRACT CITY UGB <br />,MARION COUNTY NO <br /> <br />OCCUPANT LOAD <br /> <br /> NO OF BEDROOMS <br /> <br />SUBDIVISION <br /> <br />SANE <br /> <br />PHONE: 749-2601 <br /> <br /> 35.0000 <br /> <br /> SITE NUFSER: 4275 <br /> VALUATION: <br /> <br />83 2W EFU <br />AC NO <br /> <br />MAP <br /> <br /> 51 <br /> <br />TYPE: PLUMBING <br /> <br />PERMIT OR ,APPLICATION NO: <br /> <br />CONTRACTOR, NO, <br />JOHNSON, EARL <br />SAME <br /> <br />PHONE: 749-2601 <br /> <br /> iTEM <br />WATER LINES. 1ST 100 FEET <br />SEWER LINES. 1ST 100 FEET <br />~OSILE HOME SEWER AND HATER CONNECTION <br />FLEET SURCHARGE -ZONE 3 <br />PLUMBING STATE SURCHARGE <br /> <br />900814? <br /> <br />TOTAL A~SES~ED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />QUANTITY A~OUNT <br />1 $20.00 <br />1 $30.00 <br />1 $25-00 <br /> $3-84 <br /> $3.?5 <br /> <br />$82.59 <br /> $0.00 <br />$82_59 <br /> <br />BALANCE DUE $0.00 <br /> <br />PAYEE: JOHNSON, EARL ./~j~_~_ . RECEIPT NO: 8799 <br />RECEIVED BY: CL .......... ~-,,~,c"'~';¢'~"~'"-___ TYPE, CK CHECK ~: 713 <br /> <br />~ ~[S IS NOT A PE~[T. ~[S APPL[~T[~ ~ST ~ ~ A R~Z~ P~ ~ERE ~E <br />FOLL~[NG ~8T BE ~PL~ED. [T IS ~E R~S[B[L[~ OF ~E APPL[C~T TO ~RE ~AT <br />ALL NEC~ ZNFO~T[~ H~ BE~ P~V[DED. <br /> <br />PLAN REVIEW: BY ............. [)ATE <br /> <br />RENARKS: CONN HL SL R~9871 <br /> <br />CITY JURISDICTION: BY DATE <br /> <br />,o~ ,, ~c ,s=~ R~ ~,~ OFFICE COPY <br /> <br /> <br />