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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-;'904 <br /> <br />Other <br /> <br />SIGNATURE OF APPLICANT <br /> DATE <br /> <br />TAX LOT <br /> <br />R~t DEN! [AL <br /> <br /> 1301'1 I~IAPLE LEAF <br />AUk13RA <br /> <br />OR 9'1002 <br /> <br />NE <br /> <br /> CONSTRUCTION TYPE <br /> <br /> CONTRACT CITY <br />f~tAR I r.3N OOUNIY <br /> <br />SUBDIVISION <br /> <br />rc~ApL. E LEAP1 LAKE <br /> <br />6'}'8-2683 <br /> <br />VALUATION: <br /> <br /> AR 5 <br />NO co~¢10 <br /> <br />CQIlTRA¢]'.OR, NO. 51838 <br />es~ ce~smuor~o~ LtD <br />4020 ALDERSROOK AVE SE <br />SALP~4, OR 97302-0000 <br />RHONe-: 378-0132 <br /> <br />RES,~DE.NFiAL FiXFURE,. NEW c~Nsr. <br />PLUMBING BA.5. P.... FEE <br />PLUC,~iNG ~"rArE ~RCHARGE <br /> <br />PAYEE: <br />RECEIVED <br /> <br />qUAN'ltrY Ar,~OUN'! <br /> 4 ~38.o0 <br /> SZO.o0 <br /> $2.80 <br /> <br />TO1AL AExSES..SED FEES <br />PR6¥IOU$ RECEIPTS <br />'I'Hi5 RECEIPT <br /> <br />$58-80 <br /> 58.80 <br /> $0.oo <br /> <br />BALANCE IAJE $0.00 <br /> <br /> RECEiPI NOt <br />TYPE: CHECK <br /> <br />0 <br /> <br />THIS I$ A VALID PERMIT * THIS PER~IT EXPIRE~ 180 DAY~ FRO~I ITS I~EtUE DATE. IF <br /> <br />RF_.~tARKS: 4 F~X R~4994 <br /> <br /> E. NOODLEY, ~,.RiON COUNTY BUiLDJN6 OFFICIAL / BY ~ <br />DONALD <br /> <br />~o~ # uc ~-~ ~v ,,~ OFFICE COPY <br /> <br /> <br />