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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO. 225 <br />2¢0 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 588-514.7 <br />CO'~E-A-PHONE 4:30 RM, - 8:00 A,M, <br /> <br /> am performing work on ~property ~ own or occupy. <br /> am a registered builder OR ( ) the atJ~horized representative <br /> <br /> DATE: 0?/05/89 TIME: 11:17:49a <br />OWNER: EX)RAN, TOM <br /> <br />SIGNATURE O¢ AP~LICANT~ <br /> <br /> DATE: <br /> <br />'fAX LOT: <br /> <br />90061-461 <br /> <br />RES I DENT I <br /> <br />SITUS ADDRESS; <br /> 910 ~HERYL ST <br /> AUMSVT LLE OR 9?325 <br /> <br />CONSTRUCTION TYPE: <br /> <br /> AUMSVILLE <br />CONTRACT g~TY: <br /> <br /> OCCUPANCY: <br /> <br />NO <br /> OCCUPANT LOAD: <br /> <br />MASWNG ¢,I~RE~,~X 185 <br /> SUBLIMITY OR 9?395 <br /> PHONE: ?69-?384 <br /> <br /> GI LDOW ii <br /> <br />SITE NUMB~: 7771 <br /> VALUATION: <br /> <br /> 10 4 25 8S 2N <br /> <br /> 79 97 7863.00 SF <br /> <br />TYPE: MECHANICAL PEf~4IT OR APPLICATION NO: 'nnE~9~°~240 f~ORNER: <br /> <br />~, N ~CTOR, ~ ...... ~ <br />T~M ~N ......... <br /> <br />RS 51 <br />NO MAP: <br /> <br />PO BOX 185 <br />SUBLIMITY 9?385 <br />PHONE: 769-7364 <br /> <br /> ITEM <br />DOMESTIC RANGE HOOD <br /> <br />FLEET SURCHARGE -ZONE <br />MECHANICAL STATE SURCHARGE <br /> <br />PAYEE: TOM BORON <br />RECEIVED BY: <br /> <br />QUANTITY <br /> 1 <br /> 3 <br /> <br /> AMOUNT <br /> <br /> 1.18 <br /> <br /> $28,52 <br /> $0,00 <br />18329 <br /> 0 <br /> <br />PL,~¢4 REVIEW: 8Y <br />REMARKS: HD FN <br /> <br />ON: BY <br /> <br />DATE ........... <br /> <br />FORM # MC 15.56 RE~L 11/88 OFFICE COPY <br /> <br /> <br />