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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br />~,ALEM¢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 a property I own or occupy. <br /> <br />SIGNATURE OF APPLICANT: <br /> DATE: <br /> <br />OWNER~ <br /> DALE: 09/06/90 'T,~M~; 11:34;54 <br /> <br />S~TUS ADORES.,..,..,..,..,..,.,~JT,FER, RALPH <br /> <br />TAX LOT: <br /> <br />CONSTRUCTION TYPE: <br /> <br />CATEGORY: <br /> <br />OCCUPANCY: <br /> <br />RESIDENTIAL <br /> <br />855 CLEYELAND <br /> <br />MA~LING ADDRESS: <br /> <br />P.O. BOX 12533 <br />SALEM,OR 9'7309 <br /> <br /> C~NTRACT CITY; UGB: <br /> <br />OR97325 <br /> AUMSV[LLE NO <br /> <br />AUMSVi LLE MEABO~S <br /> <br />SECTION: TOWNSNIPi ~A~l~i~. NUI',18 ER = 10231 <br /> ~ '¢'ALUAT ZON: : ZONE: <br /> <br />2 1 8S 2N <br /> <br />5q <br /> <br />TYPE; MEt,'HANJ. CAL PER~I'r OR APPLiCA'rIoN NO: <br /> <br />CONTRACTOR. NO_ 1505 <br />SALEM HEATING & ~HBE'r METAL <br />P.O. BOX 12005 <br />SALE~, OREGE~ 9?309 <br />PHONE: 581-1535 <br /> <br /> [ TF_~ <br />~ f..%TNN EC'T i ON <br />OTHER (AS PER MECHANICAL CODE) <br />FIECH..~ClICAL BASE FEE <br />FLEET SURCHARGE -ZONE ~ <br />MECHANJ, CAL 5TA'rE ~]~URCHARGE <br /> <br />PAYEE: SALEM HEAFING & E, HEEI' METAL INC. <br /> <br />27023 <br /> <br />TOTAL ~E'S~EO FEB <br />PR~¥i(.IU~ RECEIPTS <br />THiS RECEIPT <br /> <br />rOtJANT I TY <br /> 1 <br /> <br />AJ'4OUN'f' <br /> ~2.00 <br /> 3_00 <br /> $1o.90 <br /> <br /> 0.75 <br /> <br />$19_59 <br /> SO.OD <br />$19.59 <br /> <br />BALANCE ~E $0.00 <br /> <br />INVOICE NO: 28600 <br /> <br /> RECEIVED BY: PR2 ........................................................................ TYPE: OK C~ECK ~ 27594 <br /> <br />* THIS IS A VALID PER~IT * THIS PER,fliT EXPiRE~ 180 BAY8 FROM iTS ISE~E DATE+ iF <br />~ST~CTi~ C~ FOR A'P~:OF 180 ~. OR iF ~T~CTI~ FAi~ TO MEET ALL <br />R~IR~T5 OF STATE ~ ~R[~ ~NTY BUILDiN6 ~O Z~JN60RDIN~C~. THiS PE~IT <br />~ALL B~E NULL ~D ~[D. <br /> <br />REMARKS: ~ LN, RELOCATE~REPLACE APPLIANCE VENT R~3249 ~ <br />0C)NALO b.. WCYJDLEY, MARION COUN'I'Y BUILDING OFFICIAL / By ............................................................... <br /> <br /> OFFICE COPY <br />FORM # MC 15-56 REV. 4/90 <br /> <br /> <br />