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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 />I am a rogistered builder OR ( ) the authorized representative S~ONATURE OF APPLICAN'!,: <br /> 7/ -- <br /> of a registered builder, <br />The work will be performed by a registered builder. <br /> <br /> DATE: 07/0717:'1 TI:NE: '~- " "' <br /> 1 ~ ,, ~), ~ ~ TAX LOT: CATEGORY: <br />OWNER[ <br /> <br /> BI...AI N ~ DONALD RESIDENTIAL <br />SITUS ADDRESS: CONSTRUCTION TYPE; OCCUPANCY: <br /> <br /> ~ONTRACT CITY: UGB: OCCUPANT LOAD: <br /> DFTROIT OR 97;~42 DETROIT NO " <br /> <br />MAll. lNG ACgRES$; ~U ~DIVI~ION; <br /> <br /> 762~ JA(,K,:~ON HILL RD SE <br /> ,,,ALEi4 ORE ~730& SITE NUMBER: 93-~;~,68 <br /> PHONE: 585-8878 VALUATION: <br /> <br />LOT: BLOCK; : ~C~i~ ~OWNSH~P: RANGE'. ZONE: MAP: <br /> <br />WIDTH; <br /> <br />UNITS; IRREG. LOT; CORNER: <br /> , NO NO <br /> <br />TYPE: MECHANICAL PERMIT OR APPLICATIUH NO: <br /> <br />COI,(TRACTOR. Iq(]. <br />BLAIN~ DONALD <br />7623 JACKSON HILL Rg SE <br />SALEM ORE 773e6 <br />PHONE: 585-8878 <br /> <br /> ITEM <br />DOMESTIC WOOD STOVE <br />MECHANICAL BASE FEE <br />MECHANICAl.. STATE StJROHARGE <br /> <br /> TOTAL A$SESSE~ FEES <br /> PREVIOUS RECEIPTS <br /> THIS:RECEIPT' <br />BALANCE;~UE <br /> <br />QUANTITY AMOUNT <br /> 1 $7~50 <br /> $1~,00 <br /> $0,.88 <br /> <br />$18.38 <br /> $0.00 <br />$18.38 <br /> <br />$0.00 <br /> <br /> PA~EE: BLAIN, D~NALD INVOICE NO: 52050 <br /> RECEIVED BY, FN~ ................. ~ ....~ ................. TYPE: OK CHECK ~: 75?4 <br /> <br /> ~ THIS IS A VALID THIS PERMIT'EXPIRES188 DAYSFROM ITS ISSUE BATE. IF <br />CONSTRUCTION CEASES FOR AP~RIOD: IFCONSTRUCTION FALLS TO MEET ALL <br /> EQUiREMEflTS OF STATE LA~S AN~HARION COUMTY BUILDT:NG AND ZONING ORDIHANCES, THIS PERMIT <br /> ALL BECOME HULL AHD VOID. <br /> <br />RENAF~KO:F'ELLET STOVE <br /> <br />DONALD E. WOODLEY~ MARION COUNTY BUILDING OFFICIAL <br /> <br />BY <br /> <br />CUSTOMER COPY <br /> <br /> <br />