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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br />PHOI'&F_: 588-5147 8:00 - 4:30 <br />2,~,:HOUR CODE-A-PHONE: 588-7904 <br /> <br />) I am performin,g, work On a property ~ owf~ or occupy. <br />) I am a registered builder OR ( ) the authorized representative SfGNATURE OF APPLICANT; <br /> of a registered bul)der, <br />) The work will be performed by a registered builder. <br />) Other , <br /> <br /> DALE: 08/09/90 'f'I,~E: 15:08:37 <br /> HARE, C. <br /> <br /> 19573 LAKEWOOO C'f NE : CON'r~AC¥Ci+¥; UGB: <br />AURORA OR 9?002 <br /> MAR tON COdN 'l"( NO <br /> <br />USE OF BUILDING: <br /> <br />SUBDIVISION: <br /> <br />LAKENOOD ESTATES <br /> <br />PHONE: 6?8-2?42 <br /> <br />LOT: BLOCK: <br />4 <br /> <br />' s~CI'IdN: "~OWNSHIP: ' <br />AREA: ; tJ NITS1 <br /> <br />SiTE NUI~BER: 10920 <br />VALUA'I'iON: <br /> <br />RANGE: ZONE: <br /> <br />IRREG. LOT: CORNER: <br /> NO NO <br /> <br />CATEGORY: <br /> RES J, DEN [' 1AL. <br /> <br />OCCUPANCY; <br /> <br />OCGUPANT iCAD: <br /> <br />TYPE: MECtiANiCAg <br /> <br />CON'fRAC'f'OR, NO. 7594 <br />LORE~'S HEATING <br />2355 HYACINTH NE <br />:~ALE~, OR 9?303 <br />PHONE: 3?0-?840 <br /> <br /> ITEM <br />HEAT PUMP <br />MECHANICAL BASE FEE <br />FLEEr C-~RCHARGE -ZONE 6 <br />MECHANICAL STATE SURCHARGE <br /> <br />PAYEE; LORE;N'S HEA'f'~N~ <br /> <br />PERMIT OR APPbtCATtON NO: <br /> <br />'FO'FAL~E~SSED FEF_.,~ <br />PR~¥iOJ~ RECEIPTS <br />'FHI$ RECE~P'r <br /> <br />OUANTiI'Y AI"n/LXJN']' <br /> 1 <br /> $~o.oo <br /> ~'?_68 <br /> 0.80 <br /> <br />$24.48 <br /> $o.0o <br />$24.48 <br /> <br />BALANCE CUE $0,00 <br /> <br />REC~iP'f NO: 2?858 <br /> <br /> RECEIVED BY: F"B TYPEz CK CHECK ~: 846] <br /> <br />· THIS IS A VALID PEEI~IT * THIS PERI~lITEXPIRE:S180 DAY8 FRO~I ITS i~E DATE. iF <br />~ST~CTI~ C~ EOR A P~IOD OF 180 ~Y5, OR iF ~ST~CTI~ FAI~ ~0 ~EET ALL <br />R~iR~TS OF STATE ~ ~D ~RI~NTY ~UILDiNG ~O Z~iNG ORDiN~C~, THIS PE~iT <br />~ALL ~E NULL ~D ~IO. <br /> <br />REMARKS: HEAT PUMP R~2363 <br />I:X}NALD E- WOODLEY. F.4ARION COUNTY BUILDING OFFlC~AL / BY ......................... ~ ............... : ............................................ <br /> <br />OFFICE COPY <br /> <br /> <br />