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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> ~ ,..- ~HONE $88-5147 <br /> CODE-A:P~ONE 4 30 PM - 8 00 AM <br /> <br />DATE: 05/26/89 TINE: 9:18; 19a <br /> <br /> PETERS. THEODORE <br /> <br />SITUS ADDRESS <br /> <br />TAX LOT <br /> <br /> 9117 SILVER FALLS HWY <br />AUHSVI LLE OR 97325 <br /> <br />SAME <br /> <br />PHONE: 362-1555 <br /> <br />SE <br /> <br /> CONTRACT CITY UGB <br />MARION COUNTY NO <br /> <br /> SITE NUt'DER: <br /> VALUATION~ <br /> <br />7188 <br /> <br />NO NO <br /> <br />RESIDENTtAL ~ <br /> <br />NO OFSbDRQOMS <br /> <br />MAP <br /> <br />TYPE: PLUM8 ING <br /> <br />PEF~NIlT OR APPLICATION NO-- <br /> <br />CONTRACTOR, NO. 14876 <br />WESTERN LIVING <br />¢835 PORTLANo ROAD NE <br />SALEN, OREGON 97305 <br />PHONE: 393-7353 <br /> <br /> ITE~ <br />WATER LIN~S, 1ST 100 FEET <br />WATER LINES, EA. ADDL. 100 FEET <br />SEWER LINES, 1ST 100 FEET <br />SEWER LINES, EA~ ADDL. 100 FEET <br />~ILE HOME SE'NEE AND WATER CONNECTION <br />PLUMBING BASE FEE <br />FLEET SURCHARGE -ZONE 3 <br />PLUMBING STATE SURCHARGE <br /> <br />PAYEE: <br />RECEIVED BY: PB <br /> <br />15743 <br /> <br />QOANTITY <br /> 1 <br /> 1 <br /> 1 <br /> 1 <br /> 1 <br /> <br />TOTAL ASS~ED FEE~ <br />PREVIOUS RECEIPTS <br />lldI$ RECEIPT <br /> <br />BALANCE DUE <br /> <br /> REQEI PT NO: <br /> TYPE: CHECK <br /> <br />AMOUNT <br /> $20.00 <br /> ~15.00 <br /> 30.00 <br /> $15.00 <br /> $25.00 <br /> $2O.00 <br /> ~3.84 <br /> 6.25 <br /> <br />~135.09 <br />135.09 <br /> $o.oo <br /> <br />$0.00 <br /> <br /> THIS iS A V~t_ID PERt4IT >~ THI$,.:PE.R~,lZT: EXPIRES. 180 DAYS F1~61 IT~ ISE ~TE. <br />~S~CTI~ ~B FOR A P~ OF:.~80 ~,, OR IF ~CTI~ FAI~ TO <br />R~~S OF STATE ~O ~RI~ ~ 'BUI~ING ~ Z~ING ORDIN~C~, ~IS PE~IT <br />~LL B~E NULL ~D <br /> <br />REMARKS: MH CON NL, SL R'Ct?025 <br /> <br />DONALD E- NOODLEY, ~RION COUNTY BUILDING OFFICIAL / BY <br /> <br />OFFICE COPY <br /> <br /> <br />