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MARION COUNTY BUILDING iNSPECTiON <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON.973~I <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />OWN~'J'E: 12/02/91 TIME: 5;48:~4 <br />slrus ADDRESSOLOHj~* JACK <br /> <br /> 876? SILVER FALL~ ~ <br />AUF~Vi LLE UR <br /> <br />97325 <br /> <br />MARION COJNTY NO <br /> <br />MAILrNG ADDRESS. <br /> <br />SUBDIV[S ON <br /> <br />:CATEGORY: <br /> <br /> OCCUPANCY: <br /> <br /> OCCUPANT LOAD'. <br /> <br />RF~,~I DENI' iAL <br /> <br /> PHONE: <br />tOT: Bt OCK; <br /> <br />SECTIOk TOWNSHIP: <br /> <br />SITE NU~ER: 15001 <br />~^NG~ALUAT ION: ZON~: MAP' <br /> <br />WrOTll. OEPTH: AREA: UNITS: <br /> <br />RREG LOT' CORNER <br /> <br />'tYPE.~ MB;~IANIOAL PEI;;~41'r OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. 48630 <br /> Willamette Noodstoves <br />1695 f4ARKE'T S'i'REE'f NE <br />~alern, 97301-0000 <br />~E: 370--7286 <br /> <br /> ITEM <br />DO~ES'flC NOOD STOVE <br />MECHANICAL BA...~E FEE <br />MECHANICAL STATE SURCHARGE <br /> <br />PAYEE: Wf']"tamette HoodstOVeslnc <br /> <br />37103 <br /> <br />TOTAL A,.%%,.SES,,~E0 FEES <br />PREVIOUS <br />THIS RECEIPT <br /> <br />'BAL.ANCEC~E <br /> <br />QUANTITY A~!OUNI' <br /> 1 $7.50 <br /> $10.00 <br /> $0.88 <br /> <br />$18.38 <br /> $o.o0 <br />$18.38 <br /> <br />$0.00 <br /> <br />RECEIPT NO: 39061 <br /> <br /> RECEIVED BY= ¢..W12 ........................ ~ ............... TYPE,: CK C~ECK <br />~ ~HIS iS A VALID i>ER~IT ~ THIs PEF~IIT EXPIRE~ 180 DAYS ~ ITS I~E ~TE. IF <br />~ST~CTI~ C~ ~R A ~1~ OF ~80 ~, OR IF ~ST~CTI~ FAI~ TO ~EET ALL <br />~I~T~ OF STATE ~ ~D ~I~TY BUI~ING ~D Z~ING O~IN~C~, THiS PE~IT <br />~L ~E~ ~ ~D~ID. , <br /> <br />RP3~AR~: ~OD STOVE Ik~I~0431 ~,[~ <br />DONALD E+ ~NOODLEY, MARION GXi,~JN'I'Y BUILDING OFFICIAL /BY ................................................................................................... <br /> <br /> OFFICE COPY <br />FORM if MC 15,56 REV, 4~90 <br /> <br /> <br />