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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 regi~,tered builder, <br /> <br />Other <br /> <br />SIGNATURE OF APPLtCANT; <br /> <br />ow~,'I'E: 10/10/9t I'IIV)E: 17: 16:58 <br /> <br /> KE'i"CHUM, LLOYD & VERNA <br />SIfUS ADDRESS: <br /> <br /> 230 DETRO~'r RD <br />DE'T'ROZ 1' <br /> <br /> TAX LOT: I CATEGORY: <br /> RES J DENT ,(A'~L <br /> <br /> -- ', ? U~)'. ]OCCUPANT LOAD: <br /> OR 9?342 ~l i <br />............................................ -DETRE).i. T .............. 1 .......... NO ...... <br /> : NO OF BEDROOMS: <br /> <br />.°O BOX 4-53 <br />DE'FROI 'r <br />PHONE: 854-3559 <br /> <br />SUBDIVISION'. <br /> <br />WIDTH: <br /> <br /> : ~II'E NUIVl8 ER: 14430 <br /> ' VALUAT I ON; <br /> <br /> I IRRE~ LOT: !CORNER: <br /> <br />! ~ NO I NO <br /> <br /> TYPE+* MEhCHANI(~a,L PEF~Ii'F OR APPLICATiON NO: <br /> <br />C~l'~'fOR, NO. <br />KE'F~UR, LLOYD & VE~A <br />~ BOX 453 <br />og'r~i 'r <br />t~E: 854~559 <br /> <br /> I'r~ <br />FO~ AIR P~ 100000 BTU OR LE~ <br />~ESI'IC ~D STOVE <br />ME~L B~E FEE <br />~ECH~ICAL $'I'AI'E ~A~E <br /> <br />35807 <br /> <br />r. JU.~d'4 T .t l'y AIW.)UN T <br />1 $6_ 90 <br />1 $?. 50 <br /> $10.00 <br /> $1.~8 <br /> <br /> 'f'OTAL ASS~ED FEb $24..68 <br /> PREVIOUS RECEIPTS $ 18.38 <br /> THIS RECEiP'F $6.30 <br /> <br /> BALANCE CUE $0+ 00 <br /> PAYEE= K£TCHUM, LLOYD & YERNA INVOICE NO: 37914 <br /> RECEIVED BY: Dffi2 : TYPE: tN CHECK ~: O <br /> ~ THiS IS A VALIO PIERffilT:~ PEI~,t[T EXPiRE~ 180 DAY~ ~ ITS 18...~UE DATE. IF <br />ODI'4STRUCTI(]N ~ FOR A PERIOD OF 180 DAYS; OR I:F ~RUCTIC)N FA,EL~ TO ~ ALL <br />REiQLm,[~'I~ ,5TATE ~ ORDI'N,M4OE~. THiS PEI~IIT <br />~,ALL I~E NULL AND VOID. <br /> <br /> WOOD FURNACE <br /> <br />IVtAR[ON COUN'IFy BUILDING OFFICIAL / BY ..:. .................................................. <br /> <br />FORM # MC 15-5~ REV, 4/90 OFFICE COPY <br /> <br /> <br />