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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 RM. - 8:00 A.M, <br /> <br />SIGNATURE OF APPLICANT: __ <br /> DATE~ <br /> <br />owr~d, 4, E, 09/11/89 <br /> OORAN, TOM <br />SIIUS ADDRESS: <br /> <br />'T'ZME: 8:3!:43s <br /> <br />TAX LOT: <br /> <br />CONSTRUCTION TYPEI <br /> <br />9094O--49O <br /> <br />CATEGORY: <br /> <br />OCCUPANCY: <br /> <br /> 8?9 8TH ST <br />&!,.IMSV I IwL,E <br /> <br />OR 97325 <br /> <br /> CONTRACT CITY: <br /> <br />AL ~4SVI LLE <br /> <br /> SUBDIVISION[ <br /> <br />UGB: <br /> <br /> NO <br /> <br />OCCUPANT LOAD: <br /> <br /> NO. OF BEDROOMS. <br /> <br />PO P.,O× 185 <br />SLIBi.,IM".'TY OR 97385 <br />PHONE: 789-7384 <br /> <br />LOT: BLOCK; SECTION; TOWNSHIP; <br /> <br /> DEL?tAR <br /> <br />SITE i',,UM8 EP< ~ <br />VALUAT I ON: <br />RANGE: ZONE: <br /> <br />MAP: <br /> <br />r, 6 25 <br />WIDTN: ~ CEPTN; AREA; UNITS: <br /> <br /> "5 9~5 7 ~._5_ 0O <br /> <br />S? N ) NO <br /> <br />TYPE: MECHANICAL PERHIT OR APPLICATION NO: <br /> <br />CO!',ITRAC'FOR. NO. <br />TOM DO P~.AN <br />PO BOX 't 95 <br />SUBLIMITY 9'~385 <br />PF/ONE: 769-7364 <br /> <br />55493 <br /> <br /> ITEM <br />DOMESTIC RANGE HOOD <br />DOM EXHST FANS & ORYER VENTS <br />rCBCHAN'rCAL 8ASR FEE <br />FLEET SURCHA¢,~E --ZONE 4 <br />MECHANICAL STATE SLIRCHARGE <br /> <br />90187S6 <br /> <br />TOTAL ASSESSED FEES <br />PREWI~AJS RECEIPTS <br />THI~ RECEIPT <br /> <br />$..! .... ., <br /> <br />BALANCE DUE $0 00 <br /> <br />:'AVE£. "or',,: :)ORAN CONST /~ INVOICE NO; <br />R~C'5:!¥ES ~;~v': ~:'~:~ ~/ TYPE'= !N CHECK ~: 3 <br /> <br /> THIS iS NOT A PE~IT. ~ZS,,~PLICA%I~ ~ST ~ ,TH~ A ,R~I~ PR~E~ ~ERE <br />FOLL~ZNG ~ST BE C~PLETED.? ,~' ~HE,,, ~SI8~'L~ OF ~E APPLIC~T TO A~RE THAT <br />ALL NECE~ARY INFO~TI~ H~s,,BE~ P~DED- ' ' <br /> <br />::,>_AN RE'VIEW: $v .......... ~ATE ............ CiTY JURISDICTION~ BY .......... [.aTF <br />':<EMAR~S: H0 CN , , ' <br /> <br />~IO.M ~ MC ~.~ ~V ~/~ O~:FICE COPY <br /> <br /> <br />