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MARION COUNTY BUILDING INSPECTION <br />SENATOR 6LDG NO 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 588-5147 <br />OODF-A-PHONE 4::30 P.M, - 8:00 A,M <br /> <br /> of a registered builder <br /> The work will be performed by a registered builder <br /> <br /> this document I <br /> DATE.- 10/27/88 TIME: 11:04:3Ba <br />?OWNE~ ............................................ ~^~ L6T <br /> SCHANTIN, DIANE <br /> <br />~ ¢,~,T EG'O R Y <br /> RESIDENTIAL <br /> <br />[ ~¥us'^~oseSS ......................................... [ 66,,STROBTIdN TYP~ ' ..... <br />13444 BLUE ~KE CT NE 2 ~X~'CiTY :b'G~ <br />~ AU~ 0R 97002 <br /> <br /> LAK~D ESTAT~ <br /> <br /> ~ONE: 678-2519 SITE NU~ERt 5572 <br /> VALUATI~: <br /> <br /> (BLOCK ~SE~Y~5~ .......... :TOWNShiP : RANG~ ;'~8~ ....... <br /> <br />TYPE: MECHANICAL <br /> <br />CONTRACTOR. NO. <br />~ANTIN, DIANE <br /> <br />PERMIT OR APPLICATION NO: 12181 <br /> <br />PHONE: 678-2519 <br /> <br /> ITEM <br />DOMESTIC WOOD STOVE <br />MECHANICAL BASE FEE <br />FLEET SURCHARGE -ZONE 6 <br />MECHANICAL STATE SURCHARGE <br /> <br />C~JANTITY ANOUNT <br /> 1 $?.50 <br /> $10.00 <br /> ~?. 68 <br /> 0.88 <br /> <br />TOTAL ASSE~D FEES $26.08 <br />PREVIOUS RECEIPTS $0. O0 <br />THIS RECEIPT $26.06 <br /> <br />BALANCE DUE $0. oo <br /> <br /> 12933 <br />PAYEE~ <br /> DIANE <br /> ~"~'-'"' TYPE: CK CHECK ~: 2805 <br />RECEIVED BY: E)N ........... ~ <br />* THIS TS A VALID P~ZT * ~IS ~ ~Z~ 180 ~ F~ ITS I~E ~TE. ~[L <br />~CTI~ C~ FOR A PERIOD ~F 18'0 :~5~, OR IF ~TI~ FAI~ TO ~ IT <br />R~[R~TS OF STATE ~ ~D ~RI~ ~ ~ILDI~ ~D Z~I~ 0~I~, ~I~ P~ <br />~L BEdE NULL ~D ~ID. <br /> <br />RECEIPT NO** <br /> <br />RE~RKS: ~S R~6090 <br /> <br />DONALD E. WOODLEY, NARION COUNTY BUILDING OFFICIAL / BY <br /> <br />FORM ~¢ MO 15,58 RE¢ 6'87 OFFICE COPY <br /> <br /> <br />