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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: 588-7904 <br /> <br /> I am performing work on ~ property I own or occupy. <br /> I am 8 registered builder OR ) the authorized representative <br /> o a registered builder, <br /> The work will be performed by a registered builder, <br /> Other <br /> f have read ~d,~gree to the t~rms stated on the reverse side of <br /> <br />DATE: 0g/~/91 'r'~ME: 11:48:55 <br /> CH1APPiNI, I~A~ELO <br /> <br /> 5028 BtjIV~RE DR <br />AU N¥:3V i LL.E OR <br /> <br />PHONE: 682-3614, <br /> <br />LOT: BLOCK: <br /> <br />2 <br /> <br /> J AREA; <br /> <br /> CA~ADtE PARK <br /> <br />WORK ............ <br /> ~ S$1'E NUMBER: 143~:¢ <br /> ~ VALUAT iON: <br /> <br />RES t DEN ] 1 AL <br /> <br />fYPE: I~ECHAN I CAL <br /> <br />CON tRACTOR, NO. <br />C;H IAPPiN;~ , ~ARC~LO <br />~5Af',IE <br /> <br />PHONE: 682-36%4 <br /> <br />PE~;('f' OR APPLICATION NO: 35645 <br /> <br /> iTEM <br />[,~¢,IES'f'JC WOOD STOVE <br />MECHANICAL BASE FEE <br />NECHANiCAL $'f'A'fE E:AJRCHARGE <br /> <br />PAYEE: ~HiAPPINI, t~ARCELO <br /> <br />WORK <br /> <br />TOTAL A,?.%SE~ED F~ES <br />PREVIOUS RECEIPTS <br />THiS RECEIPT <br /> <br />82,5 <br /> <br />~UAN'I'iI'Y ANOUNt <br /> ~ $7.50 <br /> $10.00 <br /> $0.88 <br /> <br />$18.38 <br /> $0.00 <br />$18.38 <br /> <br />BALANCE DUE $0.00 <br /> <br />RECEI P'¥ NO: 37551 <br /> <br /> ': ' CL <br /> REf_,~JV['~D aY: '[YP~.' OK L,14ECK ~: 0 <br />................................. 2:: ....... :,2:2::-%:- '7 ":' -.:.:~'- .... =:..~::_:;~; -~7_ ............................. <br /> ~ THiS IS A VALID PERffllT * THiS PEBiT EXPiRE~ 180 I~'f'~ FROI~I ITS ISSUE DATE. IF <br /> CONSTRUCTION CEASES FOR A PERIOD OF 1BO BAYS, OR[F COt~TRUCTION PAILS TO tflEET ALL <br /> RB~JIRI~4~NTS OF STATE LA~ ~ND ~ARiON COUNTY BIJILDING AND ZONING ORDIN/~CE$, THiS PE~4[T <br /> 5HALL 8ECI~flE NULL ANI] VOID. <br /> <br />REMARKSt 9~27-91 ~XISTiNG iNSERT R~29BO <br /> <br />DONALD ~, WOODL~Y, t4ARION COUNI'Y BUILOING OFFICIAL / MY <br /> <br />FOaM # MC 15-56 R~V. 4/90 OFFICE COPY <br /> <br /> <br />