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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO, 225 <br />220 HIGH STREET NE <br /> SALEM, OREGQN 97301 <br /> <br />PHOI~ ~ 588-5147 <br />OODE-A-PHOh.'~_ 4:30~P.M. - 8:00 A.M, <br />I am pBrforming work on a property I own or occupy, <br />I arrl a r~istPred builder OFf ) t~e authorized representative SIGNATURE OF APRLICANT: <br /> <br />Other__ <br /> <br />01/:91/90 TIME: 13.'14:58 <br />EAJTTER, PJ~L PH <br /> <br />fAX LOT'. <br /> <br />RESIDENTIAL <br /> <br /> 880 9TH ST <br />AUMSV ! LLE <br /> <br />USE O? BUILDING: <br /> <br />OR 97325 <br /> AUMSV[LLE NO <br /> <br /> SUBDIVISION <br /> <br />PO 80X 1';'533 DEI-h~R <br />SALEM OR 97309 <br />PHONE: 588-23?2 SITE NUN~ERt <br /> VALUATION <br /> LOT' BLOCK. SECTION: TOWNSHIP. ' RANGE: <br /> <br /> '74 100 '7400. 8F NO <br /> <br /> 8688 <br /> <br />CORNER: <br /> <br /> NO <br /> <br />TYPE: ~4EOtANICAL PERNIT OR APPL!CATION NO: 21653 <br /> <br />CONTRACTOR, NO. 1505 <br />SALEM HEATING & SHEET METAL INC <br />P.O. BOX 12005 <br />SALEM, OREGON 9?309 <br />P~ONE: 581-15:96 <br /> <br /> ITEM <br />GA~ CONNECTION <br />FORC AIR FURN 100000 BTU OR LB <br />DOMESTIC RANGE HOOD <br />DOt~ EXHST FANS & DI:~'(ER VENTS <br />NECHANIOAL BASE FEE <br />FLEET SURCHARGE -ZONE 3 <br />MECHANICAL STATE SURCHARGE <br /> <br />PAYEE: SALD4 HEATING & SHEET METAL INC. <br /> <br />TOTAL AS~F_$~ED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />(~JANTITY ANOUNT <br />1 $2.00 <br />~ $6.00 <br /> $4.50 <br /> 3 sg.00 <br /> $10.00 <br /> ~D.B4 <br /> 1.58 <br /> <br />$36.92 <br /> $0.00 <br />$36.92 <br /> <br />BALANCE QJE $0.00 <br /> <br />INVOICE NO: 22961 <br /> <br /> REOEIVE1D BY: PD ........ : TYPE: IN CHECK #: 0 <br /> <br />(33NST~'I~ON CEASES FOR A PER[OD OF 180 DAYS, O~ IF CON~ION FAILS TO I~EET ALt. <br />I~EI~JIR~ OF STATE ~ /INO t~IAEION COUNTY 8UII.DINB $~NO ZONING OI~INANOES, THIS BIT <br />~HALL BBDOI~E NULL ~aClD VOID. <br /> <br />RD4ARKS: GAS FUf~N HD FN <br /> <br />DONALD E, ~OODLEY, ~qRION COUNTY BUILDING OFFICIAL / BY <br /> <br />OFFICE COPY <br /> <br /> <br />