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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: 588-514'7 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> of a registered builder, <br /> The work will be p~dormed by a registered builder· <br /> O~her <br /> I have read and agree to the terms 8teted on the reverse side of <br /> ti318 docurr~eRt. <br /> <br />BATE+. 04/03/91 'rIME.* 9,4,3:51 <br />OWNE~: <br /> EB~CARD"~, JOHN <br />$1TU~ ADDRESS: <br /> <br /> 11913 ',d STAY'tON RD <br />/:~UMSV I LLE OR 97325 <br /> <br />USE OF BUILDING: <br /> <br />~ ~AX I. OT; ICXTCGORY: <br /> ' RET~J 0~ 1' 1 AL <br /> <br />· CONSTRUCT ON TYPE'. i OCCUPANCY: <br />! CONTRACT CIT~Fi I UGS: i OCCUPANT LOAD: <br /> <br />PHONE: <br /> <br />TYPE: MECHANICAL <br /> <br />CONTRACTOR, NO. <br />EF3,NAROS, JOHN <br /> <br />PER~1I'r OR APPLICATION NO: <br /> <br />31301 <br /> <br />OO~IP.:ST tC NOOD STOVE <br />¢4ECHANiCAL BA,~E FEE <br />MECHANICAL S'FATE SURCHARG£ <br /> <br />r.,XJAN'rITY AMOUNI' <br /> 1 $?.50 <br /> $~0.00 <br /> $0.88 <br /> <br /> RECEIPTS <br /> THIS REOE~P]' <br /> <br /> BALANCE OUE <br /> <br />PAYEE: ED~AR0~ JOHN RECEIPT NO: 33052 <br />RECEIVED BY: Gl : TYPE: CK C.'HE~K ~; 3186 <br /> <br />$18.38 <br /> $0.00 <br />$18.38 <br /> <br />$0.00 <br /> <br /> THiS ,{5 A VALID PEI~4[T * THIS PE.,F~I:T !EXPI:RES 180 IDAYS:FR0f4 ITS IS-~JE DATE. <br />COf~iTRUCTiON CEAS~ I=OR A, PERIOD CE FAIL~ TO MEET ALL <br />RI~XJIRE~TS Oi= STATE I.~ AND r4ARZON 'C~TY: BO!LDI~NG'AND Z~iNG ORDi~C~, THIS <br />~L ~ NULL ~D ~10. ' : :: <br /> <br /> R~RKS~ PELLET ~085 <br /> ~ALD E. ~0LEY, ~R[~ ~NTy BUiLDinG 0FFiC[AL / B~ .................................................................._~ <br /> <br />FORM # MC 15-56 REV. 4/~0 OFFICE COPY <br /> <br /> <br />