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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 PM. - 8:90 A.M, <br /> <br />I am performing work on aproperty I own or occupy, <br />I am a registered builder OR ( ) the authorized representative <br />of a registered builder, <br />The work will be performed by a registered builder. <br />Other -._ <br /> <br />DATE: ......... <br /> <br />owr~t~T E: .C;.'_~/': 2/89 <br /> <br /> ,'~RA,~ TOM <br />S TUS ADDRESS <br /> <br />T'II~E: 9:13:20a <br /> <br /> 870 iF'"H ST <br /> AUMSV~' LLE <br />USE OF BUILDING: <br /> <br />OR 97325 <br /> <br /> 90040-490 ,~ .......... ...... · <br />.N._If,ISV I LLE NO NO. OF 8EOROOMS: <br /> <br />8335 <br /> <br /> DEL~4AR ; <br /> PO 80X 185 <br /> SUSLT.~VlITY OR 87885 <br /> PHONE: 769-736/; SITE NUMBER; <br />LOT; BLOCK: SECTION: TOWNSHIP: RANOICALUAT Z ON: ZONE: <br /> <br />WIDTH; ~ DEPTH: 5 AREA: 25 dNJT$: 88 IRREG. LOT; 21~J CORNER: <br /> ~5 95 '7 !28.00 SF bio NO <br /> <br />MAP: <br /> <br />"?'YPE: PLUMBING PERI~]'"F OR APPLTCAT:C)N i',JO: '!8758 <br /> <br />CONTRAS'fOR, NO. 28838 <br /> <br />P.O-BOX 'ISS <br />..~.U2,!SV~L. LE~ OR 97325 <br />PriOR E: '749 ~.29 ? I <br /> <br /> ] <br />r<ESZOENT~AL ~'iXTURE, ~¢E.~4 <br />i:)....U~aBING E3.~SE FEE <br />FLEET SJRChARGE --ZC)~E 3 <br /> <br />QLrANT ]] TM AFIOUN T <br /> 6 $5~ <br /> }:2'3 <br /> $ 2. ?, 4 <br /> <br />TOTAL ASSE~ED FEES <br /> ~REV~OUS RECEIPTS <br />'~HZ.S RECE]:P7 <br /> <br />~I8 ~, 54. <br /> S 1' _ 54 <br /> $0, <br /> <br />BALANCE ~JE 'I C. "~'.,., <br /> <br />:,/,, /~t~: iNVOICE NO: <br />'.'*' "x}v ~,. :P" .>~ TYPE~ .,HEL,K <br /> <br />* THIS IS A VALID PER~IT ~ qi.Hr,[S: PERf4~:T EXp:['RES.:IS0 BAYS. FRQN ITS [~E DATE. IF <br />~ST~CT[~ C~ FOR A .PER'~OD 'OF 180...DAYS, OR [F ~S~CTZ~ FAILS TO ~EET ALL <br />RE~[R~TS OF STATE ~ ~D..~R[~'~N~ BUILDING ~D Z~ING ORDINANCES, THIS PE~IT <br />~ALL 8E~E NULL AND VOID.. YI,' . .:, .. ..... :... . ... <br /> <br />RrE~ARKS- 6 FIX .... <br />OONaLO 6. ~lOO0t. BY, 'wAR,ON COUHTY BUILDING OF~IC;~L / BY __~ ...................... <br /> <br />OFFICE COPY <br /> <br /> <br />