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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 RM - 800 A M <br /> <br />[ am a re~lsfered buildor OR f __ ~uthorized representativo SIGNATURE OF APP( lOAN <br /> <br />DATE: 01/12/89 TIME: 11t2g:31a <br />OWNER ~X LOT CATEGORY <br /> RIOPELLE, MR. <br /> <br />RESIDENTIAL <br /> <br /> 13275 OAIGQUIRY LAKE DR NE CONTRACT CITY [-JG8 <br />AURORA OR 97002 <br /> MARION COUNTY NO <br /> <br />SAME <br /> <br />PHONE; 678-1565 <br /> <br /> 2 <br /> <br />3 <br /> <br />SUBDIVISION <br /> <br />LAKENOOD ~4 <br /> <br />SITE NUMBER: 6348 <br />VALUATION: <br /> <br />NO NO <br /> <br />MAP <br /> <br /> 5 <br /> <br />TYPE: MECHANICAL PERMIT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. 14008 <br />ROTH HEATING <br />593 SE 1ST AVE <br />CANDY, OREGON <br />PHONE: 286-1249 <br /> <br /> ITEl4 <br />GA,.S CE~NECTION <br />FORC AIR FURN 100000 BTU OR LESS <br />OTHER (AS PER MECHANICAL CODE) <br />MECHANICAL BASE FEE <br />FLEET SURCHARGE -ZONE 6 <br />MECHANICAL STATE S~.JROHARGE <br /> <br />PAYEE: ROTH HEATING <br />RECEIVED BY: al <br /> <br />13487 <br /> <br />QUANTITY AlviOUNT <br />1 $2.00 <br />1 $8.00 <br /> $3.00 <br /> $10.00 <br /> 27.68 <br /> 1.05 <br /> <br />TOTAL 4,SS~ED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />$29.73 <br /> <br />$29.?3 <br /> <br />BALANCE DUE $0.00 <br /> <br />RECEIPT NO: 14303 <br />TYPE: OK CHECK ~: 2391 <br /> <br />* THIS IS A VALID PE~IT * THIS PERMIT EXPIRB~ 180 DAYS FROM ITS I.~S4JE DATE. ~F <br />CONSTRUCTION OBASES FOR A PERIOD OF 180 DAYS, OR IF CONSTRUCTION FAILS TO MEET ALL <br />REQUIREMENTSOFS STATE LAWS AND MARION COUNTY BUILDING AND ZONING ORDINANCES, THIS PER~IT <br />SHALL BECOME NULL AND VOID. <br /> <br />RENARKS: GAS FURN,WH VENT ONLY R~5817 <br />DONALD E- ~E)OOLEY, MARION COUNTY BUILDING OFFICIAL / BY ...... _~,_~ .................... <br /> <br />~O~M ,MC,~-~ .~ ,,',~ OFFICE COPY <br /> <br /> <br />