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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 /> Other__ <br /> I h,~ve read and agree to the terms stated on the reverse side of <br /> this doour~ent. <br /> <br />'OWNER: <br /> NELSEN ~ HELVZN <br /> <br /> 10152 LEVERMAN RD <br />AUMSVILLE <br /> <br /> SE : OON+RA~ 61~Fi ........ !'~i i OCCUPANT LOAD: <br />OR 97325 <br /> MARION COUNTY <br /> <br />PHONE: 749-1812 <br /> <br />'WIDTH: !DEPTH: <br /> <br /> SITE NUMBER: 5534 <br /> VALUAT I ON: <br />,S,~bfibfi; TOW~.~i,~': ...........................................: ~*Nae , zone; I'G~'&' ........................... <br /> <br /> AR~A: UNITS: , IRREG. LOT: <br /> NO i NO <br /> <br />TYPE: MECHANICAL PERMIT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. 48848 <br />MELTONS HEATING <br />1942 MCGILCHRIST SE <br />SALEM. OREGON 9?902 <br />PHONE: ~78-7482 <br /> <br /> I TEN <br />GAS CONNECTION <br />FORC AIR FURN 100000 BTU OR LESS <br />MECHANICAL SASE FEE <br />FLEET SURCHARGE -ZONE 3 <br />MECHANICAL STATE SURCHARGE <br /> <br />PAYEE: MELTONS HEATING <br />RECEIVED BY: DM <br /> <br />11239 <br /> <br />QUANT I'TY AMOUNT <br />1 <br />1 $5.00 <br /> $10.00 <br /> 9.84 <br /> 0.90 <br /> <br /> TOTAL, ASSESSED FEES $22.74 <br /> PREVIOUS RECEIPTS $0.00 <br /> THIS RECEIPT $22.74 <br />BALANCE~::::BUE , : $0+ 0O <br /> <br /> ,: RECEIPT NO: 11950 <br /> :TYPE:: OK CHECK ~: 2311 <br /> <br />:* THIS ;I8 A VALID PE~IZT * THIS PERI,,IIT EXP:iRE~ lB0 DAYS,.FRON TTS Z~E DATE. If= <br />CONSTRUCTION CEASES FOR A PERIOD OF 180 DAYS~ OR :'~F :CONS'ERUCTION FAILS TO NEET ALL <br />R~QUIR~ENTS OF ~TATE LAN~ AND NARION COUNTy BUILDING:;AND ~ONING ORDINANCe, THIS PERMIT <br />SHALL 8ECONE NULL AND VOID. ,:: ~ <br /> <br /> , <br /> <br />RECC~R~: ~ FURNACE RCC490~I ,,"' <br />OONALD E. NOODLEY, MARION COUNTY BUYLDING OFFICIAL'/BY <br /> <br />ronM # MO 1~-56 REV ~/87 OFFICE COPY <br /> <br /> <br />