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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLC¢G, NO, 225 <br />220 H4'GH 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 />f am performi~¥j work on a property I own or occupy. <br />[ am a registered builder OR the authorized representative <br /> of ,3 registered buitder, <br />The work will be performed by a reglsterod builder. <br />Other <br />I have read and agree to the terr~S Sta~ed on ~he reverse side of <br /> <br />,6~7~E.~ 08/26/88 TIME: 9.:4t:.23a ,TAX LOT; <br /> DONOVAN. ,JACK ~ ~OCCU~ANCY; <br /> RES~ DEN~ ~ AL <br /> , CONSTrUCTiON TYPEz , <br /> <br /> 410 O~ CONTRACT C TV uea ~ OOCU~N~ E6~6' <br /> ; ~ <br /> AU~VILLE 9? 325 ¢ <br /> <br /> PO BOX 673 <br />' AUMSVILLE <br /> PHONE; 749-1158 <br /> <br /> i~LU~K: <br /> <br />SITE NUMBER.' 5308 <br />VALUATION: <br /> <br /> N,.9 .............................. <br /> <br />TYPE: MECHANICAL <br /> <br />CONTRACTOR~ NO. 7594 <br />LOREN'S HEATING <br />2355 HYACINTH NE <br />SALEM, OR 97303 <br />PHONE: 370-7640 <br /> <br /> ITEM <br />GAS CONNECTION <br />FORC AIR FURN 100000 BTd OR LESS <br />rZCS NATER HF_..ATER <br />MECHANICAL SASE FEE <br />FLEET SURCHARGE -ZONE 3 <br />~IECHANICAL STATE SURCHARGE <br /> <br />PERMIT OR APPLICATION NO: 10718 <br /> <br /> ~JANTITY AMOUNT <br /> 1 $2.00 <br /> 1 $6.00 <br /> 1 $7.50 <br /> $10.00 <br /> $3.84 <br /> : $1 <br /> TOTA~,A.SSES>SED:FEES, $30~62 <br />,PREVIOUS RECEIPTS,, , $0.00 <br />THIS RECEIP~ : $30.62 <br /> <br />$0.00 <br /> <br />PAYEE: LOREN's HEATING :' :: :: ', ::', ,, ,fN9OiCE NO.* 11426 <br />RECEIVED BY: ~ .............. ____~..;._..., ........ : __ ,:rFYPE: :IN :CHECK ~: 0 <br />~ THIS IS A VALID PER~,,1XT x< THIS PERNZT EXPiRES:,180' ,DAY~,¢:FBON /~;TS 'fSSUE DATE. ZF <br />CONSTRUCTION CEASES FOR A PERIOD OF 180 BAY'S:;. 'OR: ?F CON$TRLIOT~ON FAILS TO NEET ALL <br />REQUIREMENTS ?,.F., ,ST.AT~ ~,L~N~ AND MARION couNTY ::BUIL6~:NG ANDi;ZONJ;N6 <br /> ORDINANCES, THIs PER,lIT <br />~HALL 8ECONE ~u~-~- ~u vuzu. <br /> <br />REMARKS: FURN/GA~ ~H/GAS LINE <br />DONALD E. k~OOOLEY. MARION COUNTY BUILDING OFFICIA~ '/ 8~" <br /> <br />¢O~M * MO ~5-S~ R~V. ~/~7 OFFICE COPY <br /> <br /> <br />