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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. - 8:00 A.M. <br /> <br />DATE: 06/22,/89 TINE: 1~27~22p <br /> DORAN, TON <br /> <br />SIGNATURE OF APPLICANT: <br /> <br /> CATE: <br /> <br />TAX LOT: <br /> 90061-191 <br /> <br />RE.SI DENTIA~ <br /> <br /> 955 CHERYL <br />AUI'~V I LLE OR 97325 <br /> <br />USE Of BUILDING: <br /> <br /> CONTRACT CITY: UGB: <br />AU~VILLE NO <br /> <br />PO BOX 185 <br />~JBLIMITY OR 97385 <br />PHONE~ 769-7364 <br /> <br />3 8 25 <br /> 77 97 <br /> <br />SUBD[V]SION: <br /> <br /> SI LDON II <br /> <br />8S <br /> <br />SITE NUIV~ER: 7680 <br />VALUAT ICN: <br /> <br /> 2,N RI <br /> YES NO <br /> <br />MAP: <br /> <br />TYPE: PLUNBING <br /> <br />PERNIT OR APPLICATION NO: <br /> <br />CONTPJ~.CTOR, NO+ 28638 <br />T.G.NICHOL PLUfV~ING, INC <br />P+0,BOX 166 <br />AUF~SVILLE, OR 97325 <br />PHONE: 749-2071 <br /> <br />RESIDENTIAL :FIXTURE, NE~ CONST. <br />PLUMBING BASE FEE ; <br />FLE;ET SURCHARGE -ZONE 3 , <br />PLUMBING STATE SURCHARGE <br /> <br />9016964 <br /> <br />PAYEE: TON DORAN <br />RECEIVED BY: P8 <br /> <br />~ THIS IS NOT A PER~iT. <br />FOLLOWING I~IJST BE <br />ALL NECE~ INP-~TION <br /> <br /> [ PTS <br /> <br />BALANCE: ~JE~, <br /> <br />PLAN REVIEW: BY <br />RENAFd¢~: 8 FIX <br /> <br />QUANTITY AHOUNT <br /> :6 $54.00 <br /> $20.00 <br /> $3.84 <br /> $3.?0 <br /> <br />$81.54 <br /> $o.oo <br />$81.54 <br /> <br />$0.00 <br /> <br />NO: 18034 <br />:CHECK ~: 0 <br /> <br />PROCESS I~-IEEE THE <br /> TO AS~JRE THAT <br /> <br />DATE <br /> <br />~O~M · uc ,~-~ ~E~ 1~ OFFICE COPY <br /> <br /> <br />