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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-$147 8:00 - 4:30 <br />24 HQUR CODE-A-PHONE: 588-7904 <br /> <br /> I am performing work on a property I own or occupy. <br /> <br /> of a registered builder. <br /> The work will be performed bY a registered builder. <br /> Other <br /> <br />DATE: 11/13/91 TIME.+ 15;27:55 <br /> MC)rE, ROY <br /> <br />SIGNATURE OF APPLICANT: <br /> DATEZ <br /> <br />,OATEGORY: <br /> <br /> OCCUPANCY: <br /> <br />Rh-SI 0EN ~ iA <br /> <br /> 2033? HIGHWAY 99E <br />AURORA <br /> <br />OR §?O02 <br /> <br />'teP, Rl ON COUNTY NO <br /> <br />SU BD~VISIC)N: <br /> <br /> PHONE: 578-1632 <br />LOT; BLOCK: SECTION: TOWNSHfP: <br /> <br /> Stl'6 NUiVE~ER: 14'745 <br /> VALUATION: <br /> <br />~ANGE: ZONE: MAP: <br /> <br />IRREG LOT: NO iCORNE~o <br /> <br />'fYPE: MECHANICAL PERMIT OR APPLICATION NO: <br /> <br />36800 <br /> <br />CONTRACTOR, NO. 01911 <br /> Wo"lfemS <br />290 Young St <br />Wcx:x:Jbumn, 97071-0000 <br /> <br /> ITEM <br />GAS CONNECTION <br />FORC AIR FURN 100000 BTU OR L6~ <br />GAS WATER HEATER <br />~ECHAN~CAL BASE FEE <br />~ECHANICAL STAI'E SJR~ARf~E <br /> <br /> QUANI'ITY AMOUNT <br /> 1 <br /> 1 $6.00 <br /> ~ $?.50 <br /> $10.00 <br /> $~.~8 <br /> <br />TOTAL ~SEO FEES $26.78 <br />PRE¥IC~JS RECEIPZS $0.00 <br />THIS REOEIP'T' $26,78 <br /> <br />CALANCE DUE $0.00 <br /> <br /> 38744 <br /> 4459 <br /> <br />PAYEE: Ho"lfers lnc RECEiPI NO: <br />RECEiVeD BY: OM ..................................................................................................... TYPE: OK CHECK <br /> <br />* THiS iSA VALID pERIVlIT * THiS PERMIT ED(PIRE~; 180 DAYS FRO~ iTS iSSUE DATE. IF <br />CONSTRUCTION CF_.A~ ~OR A P~RIOD OF180 :OAYS, OR 1F OONSTRUOTICX~4 FAILS TO RF.~T AgL <br />REQUIRffi~ENTS OF STATE LAHS AND I~,1ARION COJNTYBUILDING AND ZONING OROINANCIES, THIS PERMIT <br />SHALL BECOME NULL AND VOID. <br /> <br />REMARKS: GL/F'URN/WH R~3915 ~ <br />OONALD E_ NrJOOLEY, MARION COUNTY BUILDING OFFICIAL / BY .............................. ,~ ~ ........................................ <br /> <br /> OFFICE COPY <br />FORM # MC 15-56 REV, 4~0 <br /> <br /> <br />