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MARION COUNTY BUILDING ~NSPECTION <br />SENATOR BLDG, NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON~9730~' <br /> <br /> PHONE: 588-5147 8:00 - 4:80 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />of a registered builder, <br />The work will be pedormed by a registered builder, <br />Other <br /> <br />this document, <br /> <br />AIJMSVZLLE OR 9732S i AUNSVILLE j NO j ,. ' <br /> <br />1 MAIIJNG ADDRESS: <br /> <br />PO BOX <br />AUMSVILLE OR 9'7,325 <br />E I,~OIqE,, <br /> <br />SUBDIVISION: <br /> <br /> SITE NUMBER~ <br /> VALUATION: <br /> <br />TYPE: PLUMBING <br /> <br />PERMIT OR APPLICATION NO: 9845889 <br /> <br /> ITEM <br />F;ESII)EI,II'IAL F'I~TLJRE~ AL,'~ERATIONS <br />~A'fER LINES: J. ST 100 FEE'r <br />FLUMBIN[; BASE FEE <br />PLUMB'lNG ,) f ATb_ SUF(CHARgE <br /> <br /> QiJANTII'Y AMOIJNT <br /> $99 ,, 0.~ <br /> 1 ::1[ $ :?.0 ,, (~'~ (;J <br /> $.,0.00 <br /> <br /> TOTAL ~SSESSE~ F~ES $~45,,95 <br /> PREVIOUS RECEIPTS $0. ~ <br /> THIS 'RECEIPT $145. ~5 <br /> <br /> ~L. ANgE DIJE $~,, ~ <br /> EAYEE~' 'r G Nicho], P1LmbJ, ng Inc ~x~ ~ '~ INVOICE NO: 48~95 <br /> <br />* THIS IS NOT A PERMIT. THIS APRL.ICATION MUST GO THROUGH A REVIEW PROCESS WHERE THE <br />FOLLOWiH~ MUST BE OOHPLETED. IT IS THE RESPONSIBILITY ~F THE APPLICANT TO ASSURE THAT <br /> LL NECESSARY INFORMATION HAS BEEN PROVIDED. <br /> <br />F'LAM REVIE;W: BY <br /> <br />REMARKS: 1t F'Z[X/WL <br /> <br />DATE ..............................CITY JURISDZCTION: ]~Y DATE <br /> <br />PO.M # uc ~s.so.~v. am OFFICE COPY <br /> <br /> <br />