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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM1 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 />lam ~ registered builder OR ( )theauthorizedPepresentative <br />of a registered builder, <br />The work will be performed by 8 registered builder, <br />Other <br /> <br />) <br /> this document, <br /> OATE: 08/12/92 <br /> <br /> 1Bi02 ARNOT <br /> AURORA <br /> <br />TIME: 16:18:05 <br /> <br />ROAD NE <br /> OR 97002 <br /> <br />BIGNATURE OF APPLICANT: <br /> DATE: <br /> <br /> TAX LOT <br /> <br /> CONSTRUCTION TYPE <br /> <br />CATE~!~E~ i DENT I AL <br /> <br />OOCUPANCY. <br /> <br />OCCUPANT LOAD <br /> <br />NO OF BEDROOM5 <br /> <br />SAME <br /> SITE NUMBER: <br />PHONE: 678-5158 VALUATION: <br /> <br />92~02755 <br /> <br />LOT: BLOCK SEOTIO~ TOWNSH ~S RANGE:] W ZONE EFU "~" g <br /> <br />V~i~'FH: DEPTH AREA 2'SAN]"~: AC ~RE6. Y~; DORNEI~Nr' <br /> <br />TYPE: PLUHBZN6 PERMIT OR t~iS'PLICAT'rO'I,[ '1~0:" <br /> <br />41502 <br /> <br />CONTRACTOR, NO. <br />ARESTAD~ BRUCE <br />SAME <br /> <br />PHONE: 678-5158 <br /> <br /> ITEM <br />RESIDENTIAL FIXTURE. NEW CONST. <br />WATER LINES, 1ST 100 FEET <br />PLUHBIN6 SASE FEE <br />PLUMBING STATE SURCHARGE <br /> <br />QUANTITY AMOUNT <br />7 $6~.00 <br />1 $20.00 <br /> $20.00 <br /> $5.15 <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />$108.15 <br />$108.15 <br /> $0.00 <br /> <br />BALANCE DUE <br /> <br />PAYEE: <br />RECEIVED BY: PB .................................. <br /> <br /> RECEIPT NO: <br />TYPE: CNECK ~: 0 <br /> <br /> THIS IS A VALID PERMIT * THIS PERHIT EXPIRES 180 DAYS FROM ITS ISSUE DATE. IF <br />CONSTRUCTION CEASES FOR A PERIOD OF 180 DAYS, OR IF CONSTRUCTION FALLS TO MEET ALL <br /> EQUIREMENTS OF STATE LAWS AND MARION COUNTY BUILDIN8 AND ZONING ORDINANCES, THIS PERMIT <br /> SALL BECOME NULL AMD VOID. <br /> <br />REMARKS; <br /> <br />DONALD E. <br /> <br />7 FIX iOOWATER LINE <br /> <br /> WOOOLEY, MARION COUNTY BUILDING OFFICIAL / BY <br /> <br /> OFFICE COPY <br />FORM # MC 15-56 REV, 4/90 <br /> <br /> <br />