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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGQN 97301 <br /> <br /> PHONE: 589-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am a registered builder OR ( he au her zed rep esee at ye <br />of a registered builder, <br />The work will be performed by a reg stered builder. <br />Other <br /> <br />SIGNATURE OF APPL GANT~ .................................................. <br /> bATE ................................. <br /> <br /> SITE NUMBER: 93-33183 <br />PHONE: 749-1982 VALUATION: <br /> <br />TYPE: MECHANICAL PERMIT OR APPLICATIOH NO: <br /> <br />CONTRACTOR, NO. 82347 <br />Stay,om Hea~iilg A Air Co)ldit~o <br />287 3rd S~ <br />Stayton. 97~8~0088 <br />PHONE: 769~349§ ,:~ <br /> ITEH <br />GAS CONNECTION <br />WALL HEATER <br />MECHANICAL ~ASE FEE <br />HECHANICAL STATE SUR <br /> <br />Conditio~ <br /> <br />49772 <br /> <br />QUANTITY AMOUNT <br />I $2.00 <br />1 $6.88 <br /> $10.00 <br /> $0.98 <br /> <br /> ~D;F'EE$ $18.98 <br /> $8.88 <br />~T' $18.98 <br /> <br />BALANCE DUE <br /> <br />$8.88 <br /> <br /> INVOICE NO: 52139 <br />TYPE: CK CHECK ~: 28897 <br /> <br /> PAYEE: Stay?n H{ <br /> RECEIVED BY. MB <br /> <br /> * THIS IS A <br />CONSTRUCTION <br /> EQUIREMEN~S OF STATE <br /> ALL BECOHE HULL AND <br /> <br />ITS'ISSUE DATE. <br /> <br /> IF <br /> ION FALLS TO MEET ALL <br />AND ZONING ORDINANCES, THIS PERMIT <br /> <br />REHARKS: GL~WALL HEAT~ ....... ~-, <br />DONALD E. WOODLEY~ <br /> <br /> OFFICE COPY <br />FORM # MO 15-56 REV. 4/~ <br /> <br /> <br />