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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:~0 - 4:30 <br /> 24 HOUR CODE-A-PHONE:$88-7904 <br /> <br /> I Am performin9 work on a property I own or occupy · <br /> l am a registered builder OR ( ) tho authorized representative <br /> ct A registered builder, <br /> The work will be performed by a registered builder. <br /> <br />DAT~: 10/;89/91 'f'iI"4E: 12;36:11 <br /> <br /> ~AR'f ~.N, ARTHUR <br /> <br />SIGNATURE OP APPLICANT: <br /> DATE: <br /> <br /> TAX LOT: <br /> <br /> CONSTRUCTION TYPE: <br /> <br /> 815 N 4 04 <br />At,.IC4SV [ LLE <br /> <br />OR 9'7325 <br /> <br />dONTRA~T ~1'¢Y; : gG~: <br />AUMSVILLE NQ <br /> <br />MAILING ADDRESS: SUSEHV~S~ON: <br /> <br />RE'5i DEN l <br /> <br /> PO 80X 288 <br /> ,AUI~SV I LLE §7325 <br /> PHONE.' 749-3408 SI'f~ NUC4B~R: 14'715 <br /> VALUAT iON: <br /> ........... ] ~0NE: MAP: <br />LOT: BLOCK: ; SECTION: TOWNSHIP: RANGE; <br /> <br />WIDTHI DEPTH: ' AREA; gNITS: IRREG· LOT: ~RNER'. <br /> NO ' NO <br /> <br />TYPE: I~ECHANiCAL PER~i'f' OR APPLiCA'IiON NO: 38439 <br /> <br />CONTRACTORz <br />NAR'f'IN, ARf'BUR <br />PO BOX 268 <br />AUi~SVZLLE 9 ~5 <br />PHONE: 749-3408 <br /> <br /> iTEM <br />0OMES'f'IC WOOD STOVE <br />NI~CHANiCAL BASE FEE <br />~ECHANIC~L STATE SURCHARGE <br /> <br />~UAN'T'i TY A~¢3UN 1 <br /> 1 $ 7 ,. b 0 <br /> o_ ,o.. ,o., <br /> $0_8S <br /> <br />TOTAL A~E~ED FEES <br />PREWIOU8 RECEIP'¥'S <br />THiS RECEIPT <br /> <br />$18_38 <br /> <br />BALANCE DUE <br /> <br />iNVOiCE NO: 38369 <br />TYPE~ iN CHECK ~: <br /> <br />PAYEE~ f'4AR'flN, ARTHUR <br />RECEIVEO BY: JT . ..................................................................................... :~ ......... <br /> <br />~ THIS tS A VALID PER~IT * THiS:PERMiT EXPIRES 180 DAYS FRO~I ITS IS,SUE DATE. IF <br />CONSTRUCTION CEASF_.5 FOR A PERIOD OF 180 DAYS, OR IF CONSTRUCTION FAILS TO ~EET ALL <br />REQUiRIE~NTS OF STATE LAHS ANDr~ARION COUNTY BUILDING AND ZONING ORDINANCES, THiS PERMIT <br />SHALL BEC~E NULL/~/DVOiD. <br /> <br />REIV~ARKS: EXID'IING kr~ ~ <br />DONALD E. ~ODLEY, r4ARiON COUNTY BUiLDiNG OFFICIAL / BY ............................................................. ,,,..,.~.................... <br /> <br />OFFICE COPY <br /> <br /> <br />