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MARION COUNTY BUILDING INSPECTION <br /> SENATOR BLDG, NO. 225 <br /> 220 HIGH STREET NB <br /> SALEM, OR EGCAN <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am performing work on ,~ proDerty I own or occupy <br />[ &rTl a registered builder OR ( ) the authorized representative <br />of a rogistered builder. , <br />The work will be performed by o registered builder. <br />Other <br />I h~iw~ read and agree to the terms stated on the reverse side of <br /> <br />OWNS'rE: 10/0]/91 '['JM~: 18:20:16 <br /> <br />SITUS AObRES~iL_KiN$O¢,f, ARTHUR & O~L~AR <br /> <br />1 <br /> <br />OCCUPANCY: RES!. 0EN l ~ AL <br /> <br />150 NACKEY LANE' <br /> <br /> 4220 ,~ 50'f'H NE <br /> 3ALE~ 9?305 854-3~23 <br /> PHONEt 37q-4~98 <br />LOT: MLOCK: SSC~ld~: <br /> <br />'T~WNS~IP: <br /> <br />DEl'ROi T NO ~0 0; <br /> <br />MACKEY CREEK <br /> <br /> 5I/E NUIVlBER; ..... <br />; RAN(~ALUA'I iON "i ZONE'. , MA~ <br /> <br />IRREG. LOT: <br /> <br /> NO "' NO <br /> <br /> 'IYPE: I'4ECHANiCAL PERI'41'f OR APPLiCATiON NO: <br /> <br />CON f I;~AC'] OR, NO_ <br />WJ. LKZNSON, ARTHUR & DELNAR <br />4220 ~ 80~H NE <br />GALEN 9?305 954~3123 <br />PHONE: 371-4398 <br /> <br /> l '1 EfVl <br />O~ES['~C ~OO S'IOVE <br />I~CHAN]CAL 8A~E F~E <br />I~ECNANICAL STATE CSU~HARGE <br /> <br />PAYEE: t4iLKir4,~ON, AR'I-HUR & DELMAR <br /> <br />35831 <br /> <br />TOTAL A~E$%ED FEES <br />PREVIOUS RECEIPTS <br />THIS REC~.[P'I' <br /> <br />QUAN~'i[Y AMOUNt' <br /> <br /> $10,o0 <br /> $0-88 <br /> <br />$18.38 <br /> $0_00 <br /> <br />BALANCE DUE $0.00 <br /> <br />[NVO.[CE NO: 3? ?4,5 <br /> <br /> RECEIVE0 BY: DM2 'IYPE: I.N ~iECK ~:: 0 <br /> THiS iS A VALID PEI~IlT * THi~ PER~4iT EXPIRE~ 180 DAY~ FROf*i 1TS i~E OA'rg. iF <br />(~ST~CTI~ 6~ FOR A PERIOD OF 180 DA~, OR iF ~8T~CTi~ FAi~ TO ~EET ALL <br />~iR~TS OF ~ATE ~ ~O ~Ri~ ~NTY 8giLDiNG ~O Z~ING ORDIN~C~. THiS PE~ <br />~ALL 8~E NULL ~B VOID. <br /> <br />RE'~ARKS: EXIS'fiNG WS <br /> <br />Q(.)N/,,D H, NOODLE'Y, I'flAR.[CN COUNTY BUiLDiNG OFFICIAL / BY <br /> <br />FOR~ ~ MC ~o-~e REV, .~ OFFICE COPY <br /> <br /> <br />