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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> this document. <br /> <br /> DATE: 10/15/92 lIME: 13:14:42 <br />OWNER: <br /> BEISLAY, GARRY <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> SIGNATURE OF APPL CANT. <br /> <br />RESIDENTIAL <br /> <br /> 544 N llTH <br /> AUNSVILLE <br /> <br />USE 6r ~LhlG~i <br /> <br />I MAILING ADDRF.,SS; <br /> <br /> .... CONTRACT GiT] UGB: OCCUPANT LOAD: <br /> OR 97525 HARiON COUNTY NO <br /> <br />....... NO )F BEOROOM$ <br /> <br />PHONE: <br /> <br />SITE NUMBER: 92-0~682 <br />VALL. ATION: <br /> <br /> NO 40 <br /> <br />TYPE: MECHANICAL PERMIT OR APPLICATION MO: <br /> <br />CONTRACTOR, NO. <br />BEISLAY, GARRY <br /> <br />PHONE: <br /> <br /> ITEM <br />DOMESTIC WOOD STOVE <br />MECHANICAL BASE FEE <br />MECHANICAL STATE SURCHARGE <br /> <br />QUANTITY AMOUNT <br /> 1 $7,50 <br /> $10,,00 <br /> $0_88 <br /> <br />TOTAL, ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />$18,38 <br /> $0.00 <br />$18.38 <br /> <br />BALANGE DUE $0.00 <br /> <br />PAYEE: BEISLAY, GARRY RECEIPT NO: 45318 <br />RECEIVEO BY: CL ........................... L ....... TYPE: OK CHECK ~: 125i <br /> <br />* THIS IS A VALID PERMIT · THIS PERMIT EXPIRES 180 DAYS FRON ITS ISSUE DATE. IF <br />CONSTRUCTION CEASES FOR A PERIOD OF 180 DAYS, OR IF CONSTRUCTION FAILS TO MEET ALL <br />EOUIREMENTS OF STATE LAWS ANO MARION COUNTY EIUILOING AND ZONING ORDINANCES, THIS PERMIT <br />SALL BECOME NULL AND VOID. <br /> <br />REMARKS: NS ~ <br />DONALD E. ~OODLEY, MARION COUNTY BUILDING OFFICIAL / BY .................................................. <br /> <br /> OFFICE COPY <br />FORM # MC 15-65 REV, 4~0 <br /> <br /> <br />