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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 8:00 - 4:30
<br />24 HOUR CODE-A-PHONE: 588-7904
<br />
<br />The work will be performed by a registered builder.
<br />
<br />I have reod and aDree to the terms stated on the reverse side of
<br />this document.
<br />
<br /> OWNER'. '"
<br />
<br /> E.I_SI"-I',,~ ,.0, Ir.
<br />:'~iTU~ ADDRESS:
<br />
<br />TAX LOT:
<br />
<br />CONSTRUCTION TYPE:
<br />
<br /> 8013 MILL CF,'EEK
<br />A:[ NSVI L,L.E OR ?73,: ....
<br />
<br />COUNTY N0
<br />
<br />LOT;
<br />
<br />PHONE: '7
<br /> , 49--:1,,,
<br />
<br /> BLODK~
<br />
<br /> SITE NUMBER: ?3-01858
<br /> VALUATION;
<br />
<br />SECTION: TOWNSNIP: RANGE: ZONE:
<br />
<br />IRREG. LO'~i
<br />NO NO
<br />
<br />OAT~GORY:
<br />
<br /> R E!il I QE ht'l' I A L,
<br />O~CUPANCY]
<br />
<br /> NO OF 8EOROOM$
<br />
<br />MAP:
<br />
<br />TYPE: MECHANICAL PER~IT OR APPLICATION NO: 473?9
<br />
<br />CONTRACTOR, N0. 00531
<br /> Mo'nt,',,lg of Salem Inc
<br />:1,0:1, LJn~i, on St'
<br />Salem,, 97S0:1.-0000
<br />PHONE.~ 58~-6396
<br />
<br /> ITEM
<br />~AS CONI,IEC'f ~ON
<br />HEAT PUNF'
<br />FORD AIR FURNACE LINDER ],0000~1 BTU
<br />MECHAI*t]:CAI,., BASE FlEE
<br />MECHAI,I]:CAI,,, STATE SURCHARGE
<br />
<br />QUANT I'FY AMOUi,IT
<br />]. $2 ,, 00
<br />1 $6,, 00
<br />J. $6.00
<br /> $10,, 00
<br /> $ I ,, 20
<br />
<br />TOTAl,., A,~SES,~ED FEES
<br />F'RI-_'V I OUS RECEIPTS
<br />THIS RED,;: I PT
<br />
<br />$25.20
<br /> $0.00
<br />$25.20
<br />
<br /> BALANCE DLIE $0,,00
<br /> PAYEE: Mon/:ag of Salem I~c ~ RECE):P'T Iq(~: . 49~68,
<br />
<br /> * THIS ZSA VALID PERMIT * THIS PERMIT EXPIRES 1BO DAYS FRSM ITS ISSUE DATE. IF
<br />CONSTR~CTION CEASES FOR A PERIOD OF 188 DAYS, OR IF CONSTRUCTION FAILS TO MEET ALL
<br /> EQUIREMENTS OF STATE LAWS AND MARION COUNTY D~ILDING AND ZONING ORDINANCES, THIS PER~IT
<br /> ALL BECOME NULL AND VOID.
<br />
<br />I;/EMARKS: FA FURN.¢ t'IF',~ GAS CONN
<br />
<br />DONALD E,, WOOBL, EY,, NA:C£ON CouNTY Bu,T, LD:t:NG O,-1-,I, C1AL, / BY
<br />
<br />OFFICE COPY
<br />
<br />
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