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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 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am performing work on ~ property I own or <br />I am a (egistered builder OR the authorized representative <br /> of a registered builder, <br />Tile work will be Sertormed by a registered builder. <br /> <br />have read and agree to the terms stated on the reverse side of <br /> <br />OWNEF1DA'fE.' 06/85/90 TIME.* 11.~41`+81 <br /> <br /> LD¥11VlONS, GORDON <br />SITUS ADDRESS: <br /> <br /> TAX LOT; CATEGORY: <br /> <br /> 4rJ888-000 <br />CONSTRUCTION TYPE: OCCUPANCY: <br /> <br />RE$iDENI'~) <br /> <br />12966 IvlAPL6 LEAF C'f' NE <br />AURORA OR 97002 , <br /> i.I~IAR,ION.C. OUNTY <br />USE OF BUILDING: <br /> <br />MAlt. lNG A00RESS: EUBDIVISION: <br /> <br />PH r..,'~N E: <br /> <br />WIDTH: DEPTH: AREA: <br /> <br /> si'rE NUI'4B ER: 10358 <br /> VALUAT.ION: <br /> TOWNSHIP: RANGE: ZONE: MAP: <br /> <br /> 1 W E FU 5 <br /> UNITS; IRRB~ LOT: CORNER: <br />:2 AC' NO NO <br /> <br />TYPE.* ¢flECHAN i CAL <br /> <br />~'f't:~AC'f'OR, NO. <br />LEf~$~ONS, GORDON <br /> <br />PERDIlI' OR APPLiCATiON NO.+ 24611 <br /> <br /> i 'i'E~ <br />~ F_.XHS'f' FANS & DRYER VENTS <br />MF-T~HAN1CAL BA~E FEE <br />FLEET ..~¢JRCi, iARGE -ZONE 6 <br />MECHANJ!CAL STATE SURCHARGE <br /> <br />g JAN T I l'Y AIvKDUN'I' <br /> $9.00 <br /> <br /> $0.95 <br /> <br />TOTAL ASS~ED <br />PRE'Vi OU~ RECEIPTS <br />THiS RECEI PT <br /> <br />$27.53 <br /> ,,..,o... oo <br /> <br /> BALANCE DUE $0.00 <br /> <br /> PAYEE: L~S. GORDON RECEIPT NO: 26059 <br /> RECEIVED"' BY: c"~ TYPE: CK CHECK ~t.~ 0 <br /> <br />:~ THIS 1,.~ A VALID PERM%T:*:: THI,.~ PERI~IT EXPiR~E~ 180 DA.Y~ I=R(~l ITS I~LIE PATE. 1F <br />C(]NSTI~JCTi(]N CF~ FOR A :I~ERIOO OF 180 DA~, OR IF ~TI~JCI'ION FAfI~ TO ~T ALL <br />RIg~JIR[~IENTS OF STARE I.~ <br />~ALL BBB NULL AJ~ID <br /> <br />REMARKS: 3 EXH']'S FANS /~ <br />DONALD E. NOODLEY, MARION COUN'IFY BU~LDJ. N(,¢ OFF'ICIAL / BY ...................................................................................~ <br /> <br /> OFFICE COPY <br />FORM # MC ~5-56 REV. 4~90 <br /> <br /> <br />