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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 />CDDE-A-PHONE 4::30 PM - 8 O0 AM <br /> <br /> I am performing work on 8 ¢roporty I own er occupy, <br /> I am a registered budder OR t ) tho authorized representative <br /> of a reg~slcred budder <br /> The work cyril bo performed by a regmtered builder <br /> Other <br /> I hace read and agree to the terms stated on the reverse side of <br /> th~5 docurflent <br /> <br /> DATE,' 01/26/89 TIME: 9:22-'22a <br />OWNER <br /> DORJ~N, TON <br /> <br />TA;, ~O': 9004--060 <br /> <br />RESI' DENTIAL <br /> <br /> 885 9TH ST <br />AUIv~VILLE OR 9?325 <br /> <br />USE OF BUILDING <br /> <br />MAILING <br /> <br /> CONSTRUCTION TYPE <br /> <br />AUIvlSvI LLE NO <br /> <br />SUBDIVISION <br /> <br />DEL NAR III <br /> <br /> PO BOX 185 <br /> SUBLIMITY OR 97395 <br /> PHONE; 769-~7354 SITE NUNIBER: <br /> VALUATION: <br /> <br />I eT BLOCK SFCTLON TOWNSHIP R&NGE <br /> ? 4 25 8S 2W <br />WI0]H ?4 DEPTH 104 AREA ?----6---UNfTS~9UU SF IRREG LOT <br /> NO <br /> <br />OCCUPANCY <br /> <br />OCCU~NT LOAD <br /> <br /> NO QFRFDROOM$ <br /> <br /> 6395 <br /> <br />7ONF MAP <br /> RS 51 <br />co"r~NO <br /> <br />TYPE; PLUIvl8 ING <br /> <br />CQ~TRACTOR, NO. 912 <br />EMERY & SONS CONST- <br />PO BOX 399 <br />STAYTON, ORE 9?383 <br />PHONE: 759-7751 <br /> <br /> ITEM <br />WATER LINES, 1ST 100 FEET <br />SEWER LINES, 1ST 100 FEET <br />FL, EEF SURCHARGE -ZONE 3 <br />PLUMBING STATE SURCHARGE <br /> <br />PERMIT OR APPLICATION NO: <br /> <br />13599 <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />QUANTITY AHOUNT <br />q $20.00 <br />1 $30.00 <br /> $3.84 <br /> $2-50 <br /> <br />$55.34 <br />$55.34 <br /> $O.00 <br /> <br />BALANCE DUE $0.00 <br /> <br />PAYEE: INVOICE NO: <br /> <br />RECEIVED BY: P~ TYPE: CHECK ~; <br /> <br />~ THIS IS A VALID PER~IT * THIS PERMIT EXPIRES 180 DAYS FRO~t ITS I~E DATE. IF <br />~NST~CTI~ C~ FOR A PERIOD OF 180 DA~, OR IF ~ST~CTI~ FAI~ TO NE~ ALL <br />REdIReCTS OF STATE ~ ~D ~RI~ ~N~ BUILDING ~D Z~ING ORDIN~C~, THIS PE~IT <br />~ALE BE~ NULL ~D VOID. <br /> <br />REHARKS: WATER/SEWER LINE <br /> <br />0ONAL0 WOOO EY, ARION COONTY UILOIN OF IC *L ¢ BY ............ <br /> <br />FONM,~ Mfj ~5.56 I~V 11,80 OFFICE COPY <br /> <br /> <br />