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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM~ OREGON 97301 <br /> '~J 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 occulmy. <br /> <br />I have read and agree to the terms stated on the reverse side of <br />this document, <br /> <br /> DATE; 11/.1.6/88 <br /> <br /> COR~¢4, TON <br />SITUS ADDRESS; <br /> <br /> 860 8TH <br /> AUMSVI LLE <br /> <br />use oF CuiLoiNGi <br /> <br />MAILING <br /> <br />PO BOX 185 <br />SUBLIMITY OR 97285 <br />PHONE: 769-7264 <br /> <br /> 75 ! 75 <br /> <br />TIME: 1 :,01: lop <br /> TAXLOT: <br /> 90040-500 i RESIDENTIAL /: <br /> CONSTRUCTION TYPE: <br /> <br /> OR 97325 AU~VILLE ~O ' <br /> DEL <br /> <br /> SITE NUI~ER: 5604 <br /> VALUATION: <br /> <br />5625. O0 SF NO i NO <br /> <br />TYPE: PLUMING <br /> <br />PERNIT OR APPLICATION NO: 12528 <br /> <br />CONTRACTOR, NO. 28638 <br />T.G.NICHOL PLUMBING, INC <br />P.O.BOX 166 <br />AUMSVILLE. OR 97325 <br />PHONE: 749-2071 <br /> <br /> ITE~ <br />RESIDENTIAL FIXTURE. NEH CONST. <br />PLUMING BASE FEE <br />FLEET SURCHARGE -ZONE 3 <br />PLUMBING STATE SURCHARGE <br /> <br />TOTAL AE~EE~ED' ::FEE~ <br />PREVIOUS RECE[ PT$ <br />THZS RECEIPT :' <br /> <br />8,ALANOE DUE: <br /> <br />QUANTITY ~JNT <br /> 6 $54.00 <br /> $20~00 <br /> $3.84 <br /> $3.70 <br /> <br />$81.54 <br /> $0.00 <br />$81.54 <br /> <br /> $o.oo <br /> <br />PAYEE.* T.G+NICHOL PLUMBING, INC :INVOICE NO: 13293 <br />RECEIVED BY: f:~ .... ~_.. .......... TYPE:, !N:'::~,CHECK ~: 0 <br />* miS' ' XL'i <br />~CTI~ C~ FOR A P~OD OF :180 ~; ~ .:IF.~T~I~ FAI~ TO ~ ALL <br /> <br />~ALL B~ NULL ~D ~ID. , :',~ <br /> <br />RE~RKS: 6 FIX <br /> <br />~ALD E. N~DLEY, ~RI~ ~N~ BUILDING OFFICIAL]/ 8Y <br /> <br />OFFICE COPY <br /> <br /> <br />