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MARION COUNTY BUILDING INSPECTION <br />S6NATOR BLDG. NO. 225 <br />220 HIGH S'[REET.NE <br /> SALEM, ORE~(~N 97:301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am performing work on a property I own or occupy. <br />I am a registered builder OR ) the authorized reBfesentative <br />of a registered builder. <br />fha work will be porformed by a registered builder. <br />Other <br /> <br />DARE: 10/01/91 'f'if'4E.+ 18:44:tS <br /> <br /> HA~NL~N, CLARENCE & EDITH <br /> <br />SITUS ADDRESS: <br /> <br />REtl i 13~N'Ti.a.L <br /> <br /> 165 N PA'f"T'ON ROAD <br /> OE'1'F~ t 'T' OR 97~~' CONTRACT OIT¥; UGB: <br /> ; DE T RD 1 f' ND <br />LJSF OF BUILDING: <br /> <br />OCCUPANT LOAD: <br /> <br />PL) BC, X 508 <br />L)E'F WO ! f' <br /> <br />LOT: BLOCK: :SECTION: <br /> <br /> BiI'E NUIVSER: 1445') <br /> VALUAT i F.:XN: <br />,TOWNSHIP: ' RANGE: i ZONB: <br /> <br />MAP: <br /> <br />AREA: UNIYBI IRR~G ~Y; NO ' :~RIO <br /> <br />TYPE: M~CHANICAL PERMIT OR APPLICATION NO: 35840 <br /> <br />CON'fRAC~'OR, NO. <br />HAHNLEN, CLARENCE & EDITH <br />°O BOX 508 <br />DEf'ROIT <br />~flONE: S5~111 <br /> <br /> iTEM <br />DOMESTIC WOOD STOVE <br />MECHANICAL BASE FEE <br />MECHANICAL ~FA'f'E SURCHAk~,BE <br /> <br />QUANTITY AMOUNT' <br /> 1 <br /> $'~o.oo <br /> So.ss <br /> <br />TOTAL ASSESSED FEES $'18_38 <br />PRE¥iOUSRECE!p'f'S $0-00 <br />THIS RECEIPT $38.38 <br />BALANCE 0LIE $0.OO <br /> <br /> PAYEE: HAHNLEN, CLARENCE & EDITH iNVOICE NO: 3??55 <br /> RECEIVED BY: [.)¢fl2 TYPE: ~N CHECK ~;: 0 <br /> <br />~ST~CTZ~ C~ ~R A' PERIOD OF 380 DA~; OR [F ~ST~CTt~ FAZ~ TO ~EET ALL <br />~[R~TS OF ~TATE ~ ~D ~RJ~ ~NTY:BU[LDJN6 ~D Z~JN~ O~B[N~C~, THIS PE~JT <br />~ALL B~E NULL ~O ~IO. <br /> <br />REMARKS: EXISTING <br /> <br />L,~(.)NALL) E. WOODLEY, FIARION ~N'f'Y BUILDING OFFICIAL / BY ...................................................... <br /> <br />FORM # MC 15-§6 REV, 4/~0 OFFICE COPY <br /> <br /> <br />