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MARION COUNTY BUILDING INSPECTION <br />SENATO~ BLB4~ NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OF1EGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I 8m performing work on a property I Own or occupy. <br />lam 8 rec~istered builder OR( )thea~Jthorized representative <br />of a registered builder, <br />The work will be performed by a registered builder. <br />Other <br />I have read and agree to the terms stated on the reverse side of <br />this document. <br /> <br /> OA~E; 05/18/90 TIME: <br /> Lrglv~4ONS, <br /> <br />,, ~RO~ OR 97002 <br /> <br />TAX LOT: <br /> <br />NO <br /> <br /> CAT~GORY: <br /> RES iDENTiAL <br /> OC(¢UPANCY. <br /> <br />OCOUPANt LOAD: <br /> <br />SANE <br /> <br />PHONE: 6?8-2623 <br /> <br />LOT: : BLOCK: ; sEctION: TOWN~H <br />WIDTH: DEPTH: , AREA: : UNITS: <br /> <br /> SITE NUMBER: <br /> VALUA'[' iON: <br />RANGE: <br /> <br />IRREG. LOT: <br /> NO <br /> <br />LEAF ES'I'AII'E~ <br /> <br />zoNE: MAP: <br /> <br /> EFU 5 <br />CORNER: <br /> NO <br /> <br />' TYPE: PLUNGING <br /> <br />PERMIT OR APPLICATION NO: <br /> <br />CONTRAC fOR, NO. <br />LENivYC~S, GOROON <br />SAME <br /> <br />PHr.-~E: d78-2623 <br /> <br />PLUMBiN~ BASE FEE <br />P'LEE[ SURC. HARGE -ZONE 6 <br />PLUMBING STATE ~JRCHARGE <br /> <br />PAYEE: <br />RECEIVED BY: PR <br /> <br />23981 <br /> <br />QUANlflIlf'Y AMOUNT' <br /> 5 $45.o0 <br /> $20.00 <br /> $?.68 <br /> $3.25 <br /> <br />TOTAL ~,.',.',.',.',.',.'~ED FLEES <br />THIS RECEIPT <br /> <br />;'/'5 _ 93 <br /> 75.93 <br /> $0.00 <br /> <br />~ALANCE DUE $0.00 <br /> <br /> RECEIPT NOt <br />TYPE; CHECK ~; 0 <br /> <br />* THIS Is A VALID PEI~IT * THiS PI:~IT EXPIRE~5 1BO DAYE~ FROM iTS I~E ~TE. IF <br />~T~TI~ ~ ~R A ~1~ 180 ~. ~ iF ~CT[~ FAI~ TO MEET ALL <br />~I~TS OF STATE ~ ~O ~Ri~ ~TY ~I~I~ ~D Z~ING ORDI~C~, THIS PE~iT <br />~LL B~E ~LL ~D ~IO~ <br /> <br /> REMARk: 5 FiX R~2018 y~~~ <br /> DONALD E, ~DLEY, ~Ri~ C~NTY BUILDING OFFiCiAL / B , <br /> <br />OFFICE COPY <br /> <br /> <br />