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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-~147 8:00 - 4',',30 <br />24 HOUR CODE-A-PHONE, 588-7904 <br /> <br />liME: 15;25:12 <br /> <br />MEULPSAAN$, J,Z~C~r- T <br /> <br />SIGNATURE OF At2PLICANT <br /> DATE <br /> <br />TAX LOT <br /> <br />CATEGORY <br /> <br />RES i DEN l <br /> <br />51rUS ADORESS <br /> 18017 MAPLE LFJ~F NE <br /> AURORA OR 9?002 <br /> <br />CONSTRUCTION TYPE <br /> <br />coNvlA~![ ~Y COUN] yGe <br /> <br />NO OCCUPANT t. OAD <br /> <br />MAILING AQOHESS <br /> <br />MAPLE LEAF~ LAKE ES1AT~T5 <br /> <br /> PHONE: 678-2661 <br />LOT BLOCK S~CTION TOWNSHIP <br /> 11 2 <br /> <br />sir8 NUD48ER: <br /> VALUAI iON: <br /> <br /> NO <br /> <br /> 12387 <br /> <br /> MAS <br /> <br /> AR <br /> <br />NO <br /> <br />5 <br /> <br />TYPE: MECHANICAL PEF~Ii]I OR APPLiCAFiON NO: <br /> <br />30581 <br /> <br />CON'iRAOFOR, NO. 51526 <br />B8I ~SfRUCflON LID <br />4020 ALD~Rf~ROOK AVE SE <br />,5ALF_J~I, OR 9?202-8000 <br />PHONE: 378~0132 <br /> <br /> lrF~ <br /> <br />BriC4 EXHS~ FANS & DRYER VENfS <br />~ECHANICAL BASE FEE <br />~CHANICAL S1AFE .!~JF.F-.cIHARGE <br /> <br />qUAN~I~Y AMOUNT <br />1 <br />1 $3.00 <br /> $10.00 <br /> $0.95 <br /> <br />TOTAL A,S.SESSEO F6gS <br />PREVIOUS RECEIP'fS <br />THIS R~CEiPf' <br /> <br />~19.95 <br /> $6°30 <br /> <br />BALANC~ DUE $0,,00 <br /> <br /> PAYE~: BBI CONSTRUCfION LTD RECEIPf NO: 32652 <br /> RP~CEiVED [~Y: CL 'lYRE: CK O~ECK ~; 2194 <br /> THIS iS A VALID PE~IT ~ THI~ PE~IT ~PIR~ 18~ ~ F~ iT5 I~E DATE. iF <br />~$T~CTI~ ~ FOR A ~RIOD OF 180 ~, OR IF ~T~CTI~ FAI~ TO ~T ALL <br /> <br />~A~ B~ ~LL ~D ~ID. <br /> <br />RE~ARKS: EXHIS, HP R~5048 ~ ~ <br />EXONALD ~. ~/OODbBY. ~RiON OOUNI'Y BUILDING OFFiCiAL / BY .................. ~ <br /> <br />FORM # MC 15-56 R~V 4/¢0 OFFICE COPY <br /> <br /> <br />