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MARION COUNTY BUILDING INSPECTION <br />SENATORBLDG PlO 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 ha~e read and agree fo the terms stated on the reverse s~de of <br /> <br /> IJA f ~- :: ~U/Oq/9 I liME: <br /> <br />OWNER WRIGHI , PHYLLIS <br /> <br />SIGNATURE OF APPLICANT <br /> DATE <br /> <br />'150 OETROI [ ROAL) <br />ROI~ OR 973zi~ <br /> <br />U~E OF BUILDING <br /> <br />P_O_ BOX 541 <br />t]%slRt.)II , OR 9'/342 <br />PHONE' 854-301 t) <br /> <br />CONSTRUCTION TYPE <br /> <br />CONTRACT CITY UGS <br />/]ET ROi I NO <br /> <br />SUBDIVISION <br /> HAMMOND <br /> <br />5iTE NUMBER: 11~25 <br />VALUATION: <br /> <br />LOT <br /> <br />WIDTH <br /> <br />BLOCK SECTION TOWNSHIP RANGE ZONE MAp <br /> <br />IYPE' MECHANICAL <br /> <br />C;ON T RACIOR, NO, <br />NRIGHI, PHYLLIS <br />P-O. BOX 54q <br />DE!ROi T, OR 9!342 <br />PBIJNB; 854~3B10 <br /> <br />PERF4If OR APPLiCAtION NO: <br /> <br /> i <br /> <br />MECHANICAL BASE FEE <br />~EC'HANiCAL Slii f~ 5L)RCHAR(~I; <br /> <br />PREWIOUS RECEIPTS <br />7HI5 RECEIPT <br /> <br />0UAN fi T Y AMOLIN l <br /> $ ~ 0,00 <br /> <br />$,18-38 <br /> <br />BALANCE DUE SU <br /> <br />PAYEL- NI'~iGHI, PHYLLIS INVOICE NO: 3!!3U <br /> <br /> RECEJVEO BY: OM2 TYPE: iN CHECK ~i <br /> <br />~ THiS IS A VALID PERMIT · THIS PEF~iT EXPIRES 180 DAYS FRCl~1 ITS ISSUE DATE. iF <br />CONSTRUCTION CEA,SN..~ FOR A PERIOD OF 180 DAY~, OR iF ~ST~CT[~ FAi~ TO MEET ALL <br />R~IR~TS OF STATE ~ ~D ~RI~ ~NTY BUILDING ~D Z~ING ORDiN~C~, TH[5 <br />~ALL BEdE NULL ~O <br /> <br />REMARKS: EXI;mFJNG N5 <br /> <br />LX.)NA~¢ f~, ~L)OOL~Y; MARION COUNTY BUILO[NG OFPiCiAL / BY <br /> <br />FOR~ ~ ~C ~S-S~ n~v 4~o OFFICE COPY <br /> <br /> <br />