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MARION COUN,.,T~Y B.U~.ILDING INSPECTION <br />SENA"I'~R.E~.. D~., NO, 225 <br />220 HIGR STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 588-8147 <br />CODE-A-PHONE 4:30 RM, - 8:00 A,M, <br /> <br />I am performing work on a property I own or occupy, <br />I am a reBisfered builder OR the authorized representative <br />of a registered builder, <br />The work will be performed by a registered builder, <br />Other <br /> <br />I have read and agree to the terms stated on the reverse side of <br /> <br />SIGNATURE OF APPUCANT: <br /> <br />ow~?E: 09/01/88 TINE; <br /> WHITSON. HARLEY D, <br />SITUS ADDRESS: <br /> <br />TAX LOT: <br /> <br />CONSTRUCTION TYPE: <br /> <br />CATEGORY: <br /> <br />OCCUPANCY: <br /> <br /> 13650 <br /> ALI RD RA <br /> <br />USE OF BUILDING: <br /> <br />WISTERIA DR <br /> <br />OR 9?002 <br /> <br />CONTRACT CITY: UGB: <br />MARION COUNTY NO <br /> <br />OCCUPANT LOAD: <br /> <br /> NO OF BEDROOMS: <br /> <br />gUBDIVISION: <br /> <br />SANE <br /> <br />PHONE: 878,~.5'!75 <br /> <br />SECTION; <br /> <br />SITE NUMBER: 827? <br />VALUATION: <br /> <br />NO NO <br /> <br />TYPE: MECHANICAL <br /> <br />CONTRACTOR. i'40. <br />NHITBON, HARLEY D, <br />SAME <br /> <br />PHONE: 578-5175 <br /> <br /> [ TEiVl <br />DOrY!EST'tO NOOD STOVE <br />MECHANt'CAL BASE FEE <br />FLEET SURCHARGE --'ZONE 5 <br />V!,ECBAN[CAL S"ATE SURCHARCGE <br /> <br />PAYEE: WHITSON. HARLEY <br />RECEIVED BY: PR <br /> <br />PERMIT OR APPLZCATIC~N NO: <br /> <br />18588 <br /> <br />QUANT I TY AMOUNT <br /> 1 $?. 5(-,' <br /> '~3.C0 <br /> $6. ~ s <br /> $0.88 <br /> <br />TOTAL'ASSESSED: FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />$0.08 <br /> <br />BALANCE DUE $0_ 0C <br /> <br />~EOE I P'l NOr 19717 <br />TYPE:, CK 3HECK l;t: 9 <br /> <br />~< THIS IS A VALID PEFi~VlIT ¢ THIS,PER~IT F-.XP,IRES I'80 DAYS'"Ff~4 ITS ISSUE DATE. IF <br />CONSTRUCTION CEASES FOR A ,PERIOD'OF t80' BAYS; OR" IF CONSTRUCTION FAILS TO MEET A~L <br />REQUIRENENTS OF STATE LANS AND,'N~,,R,,,I'ON COUNTY BUILBIN6 AND ZONING ORDINANCES. THIo PERNIT <br />SHALL 8ECONE NULL AND VOID. ,,, ' :',~,',', '" , <br /> <br />REMARK,~;° NS R~,.63' '~o <br />0ON, ,L E, NOO LE¥, MARION tt6aTf" aO'ZLa.,:, a' OF alAL / aY <br /> <br />~OR~ ¢ ~c ~,~ ~v ~;e8 OFFICE COPY <br /> <br /> <br />