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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 have read and agree to the terms stated on the reverse side of <br /> <br />SIGNATURE OF APPLICAN[: <br /> DATEZ <br /> <br />OWNER'. <br />DATE: O6/1 ~-/90 'r [ME= <br />SC'uS ACUH~t..rER, RALPH <br /> <br />14:41:29 <br /> <br /> 855 CLEYEL.a~O ST <br />useable 0R 97325 <br /> <br /> TAX LOT~ <br /> <br /> CONSTRUCTION TYPE'. <br /> <br />AUIv~VZ LLE <br /> <br /> SUBDIVISION: <br /> <br />NO <br /> <br />CATEGORY: <br /> <br />OCCUPANCY: RESi Dr:~;NT I AL <br /> <br />OCCUPANT LOAD: <br /> <br />P.O. BOX 12533 <br />~ALEf4,OR 9?309 <br /> <br />76 <br /> <br />AUI~:SVILLE <br /> <br /> SECTION: T6WN~HiPi ~'~.~ NUf4BER: ZONE: 10231 <br /> VA~AT l~z <br /> <br /> 25 8S 2~ ~ <br />"~"~' 7600. SE NO NO <br /> <br />MAP: <br /> <br /> 51 <br /> <br />TYPE: PLUMBING <br /> <br />PE~i'r OR APPLICATION NO; 24243 <br /> <br />CONTRACTOR, NO. <br />.SUT'rER, RALPH <br /> P.O. BOX ~25~8 <br /> SALF-~,OR 97309 <br />PHONE: 588-237~ <br /> <br /> ! 'rE3~ <br />RS.~[DENTtAL FIXTURE, NEW O~3NS'r. <br />PLUNBING r4A~E FEE <br />FLEET ~U~HARGE .~ZONE 3 <br />PLUmiNG STATE ECJRCHARGE <br /> <br />"fO~'~E~.~-~ED FEE~ <br />PRE¥I~JS RECEIPTS <br />THIS RECEzP'r <br /> <br />t.;~ANTI'fY <br /> 6 ~54.00 <br /> $20.00 <br /> <br /> 3~?0 <br /> <br />~81.54 <br /> 81.54 <br /> $o.oo <br /> <br />BALANCE DUE $0.00 <br /> <br />PAYEE: iNVOiCE NO; <br />RECEIVE0 DY: PB TYPE= CHECK ~; 0 <br /> <br /> THiS I$ A VN_ID PEi~Itl * ~ Il-liS I:~l~llT !I~XPIRE3 180 II~.YS ~ 115 IS$[1£ II~.IE. IF <br />~/~-Id~T~E NO~LL~T~DE ~L~I~.ANO IM/Id~,Ol~ ~OUNTY BLIiL,IB,I[NI~ .aND ZONIN80l:~gll~4~lC~, TH18 ~IT <br /> <br />RF_.~RKS: 6 FIX <br /> <br /> BUILDING OFFZC~AL / BY ............ ~. ................... /~,,.,. ................................. <br />OONALD <br /> E. <br /> OOUNTY <br /> <br />OFFICE COPY <br /> <br /> <br />