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MARION COUNTY BUILDING INSPECTION <br /> SENATOR BLDG. NO. 225 <br /> 220 HIGH STREET NE <br /> SALEM, OREG ,0 ~N 973..01 <br /> PHONE: 588-5147 8:00 - 4:80 <br /> 24 HOUR CODE-A-PHONE: 888-7904 <br /> <br />I am performing work on aproperty I owrl or occupy. <br />lamaregseedbuilderOl=i( ) he au horizedreplesena ye <br />of a registered builder, <br />The work will be per~orrned by a registered builder, <br />Other, <br /> <br />owr~'fE-' 10/11/91 :rJ..r4E*. '~5.0~'=t8 . TAX LOT: ' CA~FGORY: <br /> , <br /> ~LEY, LINN ~ ; RE, lB TiAL <br />SITUS ADDRESS ~ CONSTRUCTION TYPE: : OCCUPANCY: <br /> <br /> 10~44 MILL CREEK ~0 SE CONTRACT CITY: Uee; '. OCCUPANT LOAD: <br /> AU~Vl LLE OR i r <br /> <br />USE OF 8UILDtNG: <br /> <br />PHONE: 749-1027 <br /> <br />TYPE: MET. TMANICAL PER~I['¥ OR APPLICATION NO: 357t9 <br /> <br /> I 'rP_J4 <br />GA~ CONNECTION <br />MECHANICAL BA.~E FEE <br />MEE~"4,ANICAL ~TA'I'E ,tSURCHARGE <br /> <br />TOTAL:~'EC:SSED FEES <br />PREWiOUS RECEIPTS <br />THiS EEC£tPT <br /> <br />QUANfITY A~OUNT <br /> ~ $2.00 <br /> $10.00 <br /> $0.6o <br /> <br />$12.50 <br /> <br />BALANCE DUE $o.oo <br /> <br />PAYEE: RECEIP'f' NO: <br /> <br />RECEIVED BY*. 0t,12 TYPE: : CHECK <br /> <br />R~R~: ~ LiNE ~LY ~3728 ; ' :: <br />~NALO E. ~DLEY, ~RJ~ ~N'f'Y BUiLDiNG / BY <br /> <br />ICE COPY <br /> <br /> <br />