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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 performing work on a property I own or occupy, <br />I am a registered builder OR the authorized representative <br />of a registered buitder, <br />The work will be per¢ormed by a registered builder, <br />Other ........ <br />I have read and agree to the terms stated on the reverse side of <br />this document, <br /> <br /> TAX LOTZ CATE~ORg: <br /> WEINIGER~ DONNIE I RESIDENTIAL <br />A~DRE$~: ...................... CONSTRUCTION TYPE: <br /> <br /> I~701 HEATHER LN NE -C6~TM%O~'~V: ....... <br /> AURORA OR ~7~2 MARION COUNTY NO <br /> <br /> ~ITE HUNBER~ 9~-~2488 <br /> PHONE: 678-5~4 VALUATION: ', <br /> <br /> , <br /> <br /> m <br />i NO ~ NO <br /> <br />TYPE: NECHAHICAL PERNIT OR APPLICATIOH HO: 48544 <br /> <br />CONTRACTOR, NO. 14888 <br /> Roth Zachery Heating Inc <br />57~ SE 1st Ave <br />Canb¥~ ~781~-8808 <br />PHONE: 888-88~8 <br /> <br /> ITEM <br />6AS CONNECTION <br />FORC AIR FURNACE UN~ER 188~88 BTU <br />GAB WATER HEATER <br />MECHANICAL BASE FEE <br />MECHANICAL STATE SURCHARGE <br /> <br />PAYEE: Roth Zachery Heating [nc <br /> <br />TOTAL.,ASSEBSE~ FEES <br />PREVIOUS,RECEIPTS <br />fHIS RECEIPT <br /> <br />BALANCE ~UE <br /> <br />QUANTITY AMOUNT <br />1 $2.88 <br />I $6,88 <br />i $7.50 <br /> $10.00 <br /> $1.28 <br /> <br />RECEIPT NO: <br /> <br />$26.78 <br /> $0.00 <br />$26.78 <br /> <br />$~.~0 <br /> <br />58857 <br /> <br /> RECEIVE~ BY: HB TYPE: CK CHECK ~: 7480 <br />$ THIS IS A VALID PERH~T ~ THIS PERHIT EXPIRES 18~ DAYS FROH iTS ISSUE DATE. iF <br />CONSTRUCTIOH CEASES FOR A PERIOD,OF 188 DAYS~ OR IF CONSTRUCTION FAILS TO NEET ~LL <br />EQUIRENENTS OF STRTE LANS AHD NAR/OH COUNTY BI~ILDIH~ AMD ZOH~HG ORDINANCES~ THIS PERHIT <br />' ALL BECOME HULL AND VOID. , -- <br /> <br /> REMARKS: GAS CONN/WH & FURN ' <br /> ~BNAL9 E. WOODLEY~ MAR~ON COUNTY 90ILDIN6 OFFICIAL /'BY <br /> <br />FORM # MC ~-~6 nE'V, 4/~0 OFFICE COPY <br /> <br /> <br />