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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 perCormed by a registered builder, <br />Other. , <br /> <br />,' 9554 GOLF CLUB RD SE CONTRACT CITY: ~, UGB: ,~OCCUPANT LOAC: <br /> AUHSVILI_.E 0R 97325 ~ ~iARION COUNTY~ N0 ~ <br /> <br /> MARLING ADDRESS: ~ SUBOWISION: <br /> <br /> PHONE: 769-6039 SITE NUHBER: 9~-01522 <br /> VALUATION: I <br />:' LOT: BLOCK; ,*~'~OT/o'N:' i ¥~5'~ki~R-i~; ~-X'A ~'~ ,. ~' ib'R~ ~8~ <br /> <br />;~OT~ [~E~H: , AREA: m IRR~G, LOT; I coR~R: <br />, ~ UNITS: ~ <br /> <br />// <br /> <br />TYPE: MECHANICAL PERHIT OR APPLICATION HQ: 46889 <br /> <br />C,O. NTRACTOR. NO. 02347 <br />. S-t:aytor~ HEATINg. <br />207 ~rd St <br />St ay'l;on~ ~7~8,~-eeee <br />PHONE= 769-"~495 <br /> <br /> ITEM <br />GAS CONNECTION <br />FORE AIR FURNACE UNDER 180888 BTU <br />GAS WATER HEATER <br />MECHANICAL BASE FEE <br />MECHANICAL STATE SURCHARGE <br /> <br />~OTAL ASSESSE9 FEES <br />PREVIOUS '' ~" <br /> RECEIFfS <br />THIS RECEIPT <br /> <br />BALANCE DUE <br /> <br />(~UANT]JTY <br /> 2 <br /> 1 <br /> 1 <br /> <br />AMOUNT <br /> $4,,00 <br /> $6,,0~ <br /> $7.58 <br /> $10,,08 <br /> $1.38 <br /> <br /> $28.88 <br /> $0.00 <br /> $28.88 <br /> <br /> PAYEE: St'my'~or~ HEATIN~ RECEIPT NO: 49858 <br /> RECEIVED BY;; F'M2 ....... <br /> <br />~ THI~ IS A YALI~ PERHIT * ~RI~ PERHIT EXPIRE$188 9AYS FRON ITS ISSUE ~ATE. IF <br />CONSTRUCTION CEASES FORA PERIO9 OF 188 DAYS, OR IF CONSTRUCTION FALLS T~ HEET AL[ <br />EQUIREHENTS OF STATE LAWS ANB HARION COUNTY BUILDIN~AN9 Z~NING OR~INANCES~ THIS PER~IT <br /> ALL BECOME NULL ANB ¥0I~. ' <br /> <br />REMARK.%' F/A FURH,¢ <br />I) Ot,IAL..~) E,, <br /> <br />6S WTR HI'R, 6S CONN <br />MARION COUNTY BU:(L1)I:I,I8 OFFICIAL / BY <br /> <br />CORM ¢~ MC 15.58 REV, 4/~0 OFFICE COPY <br /> <br /> <br />