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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG NO. 225 <br />220 HIGH STREET NF <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 a property I own or occupy. <br /> <br />Other <br />I ~lave read and agree to the terms stated on thc, reverse side of DATE: <br /> <br />OWN~i~.TE: 01/16/92 1'iFIE: 12;~9:19 <br /> <br /> STOREY, CHP_.;5'TER ~ rHEU~r¢. <br />SITUS ADDRESS. <br /> <br />TAX LOT CATeGORY: <br />CONSTRUCTION TYP~' OCCUPANOY: <br /> <br />RESiDEN'IIAL <br /> <br /> 4'~5 CLES'i"ER RD <br />BET'ROI T <br /> <br />:MAILING ADDREGB: w~¢ <br /> <br />OR 97342 <br /> <br />CONTRACT CITY UGB ' OCCUPANT LOAD: <br />DET'RO'tT NO ,o o~ ~ooMs <br /> <br /> PO BOX 432 <br /> DETROIT <br /> PHONE: 854-3532 <br /> <br />LOT BLOCK: SECTION TOWNSHIP <br /> <br />WIOTH: 8 DEPTH ~ AREA ~ JNITS. lO <br /> 80 80 64.00. SF <br /> <br />R~GV~LUAT '[ ON' ~~ M^,. <br /> <br /> RRE~. LOT 5~ CO~NER' <br /> <br /> NO NO <br /> <br />TYPE: MECHANICAL PERMI'F OR APPLiCATiON NO: <br /> <br />CONTRACTOR, NO. <br />S'FORE¥, CHESTER & ]'H~L.~ <br />¢-Yj BOX <br />DE'FRO~'f <br /> <br /> 'FEN <br />C'X.,~Es'rlc [4OO0 STOVE <br />~EOHANICAL B,z~.~E FEE <br />1'4ECHANiCAL STATE SURCHARGE <br /> <br />PAYEE: S'FORE¥, CHESTER & THELr, IA <br />RECEIVED ELY.* P~ <br /> <br />37953 <br /> <br />OUCNN'I'iI'Y ~N'I' <br /> $?.5o <br /> <br /> TOTALASSE.ECSED FEES <br />::PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />$18.38 <br /> $o_00 <br />$~8.38 <br /> <br />BALANCE [XJE $0.00 <br /> <br />iNVOiCE NO: 39928 <br />TYPE: CK CHECK ~: 368? <br /> <br /> THIS IS A VALID PER,lIT :~, THIS PEI~IIT EXPIf~.:I~O ~ E~ I~ [~E ~TE. [F <br />~T~CTi~ C~ F~ ~ ~1~ ~ 180 ~; ~:[F ~T~TI~ FAi~ TO ~ET ALL <br />R~i~TS OF ~TATE ~ ~D ~1~ ~TY BUILDING ,~O Z~ING O~IN~C~, THIS ~IT <br />~ALL B~E NULL ~D ~ID+ : <br /> <br />RF-.NARK~: ~D 8'rOVE <br /> <br />[XJNALD E. NOOOLEY, MARION COUNTY BUILDING O~'FiCiAL / B~ <br /> <br />OFFICE COPY <br /> <br /> <br />