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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 registered builder OR the authorized represen ave SIGNATURE OF APPLICANT: <br /> of a registered builder, ' ~ <br /> <br />The work will be pedormed by a registered builder. <br />Other <br /> <br />~ ~J:]"i{J i, ..HE"RYL 157648-000 <br />FsTf'~7~6b~§~C .................................................................. ~b~TTb~-~ ......................... <br /> <br /> ~:t,$~ SMITH R~ SE <br />, ~U~3VIt.,.LE O~ ~7325 <br /> <br /> MAILING ADORES$: <br /> <br />129~ EWALD AVE SE <br /> <br />.... I J ................. ...... <br /> <br />TYPE= PLUHBING <br /> <br />CON'fRACTOR, HO,, <br />DEHU't~ CHERYL <br />:[2~0 I:,WALI) AVE SE: <br />SALEM ~7S02 <br />PltONE: 585.,,,486t <br /> <br />RE$II)EN'FIAL <br /> <br />MARION COUNTY NO , <br /> <br />SiTE NUMBER: <br />VALUATION: <br /> <br />PER~ITOR APPLICATION N~: 7852155 <br /> <br />WATER IFE$~ 1ST !00 F'ZEI' <br />WATEt IWE~, EA. ADDL~:i 100 EE~iT <br />PI_UMBtlIG STATE SJ~]~A~;E ::'"~'~:: <br /> <br />FEES <br /> <br /> PAYEE: DEHUT, CHERYL ;:i <br /> RECEIVED BY~ DM2 ;~:~ <br /> <br /> ~ TH~ IS NOT A PER~: <br />FOLLO~IN~ NUST BE <br /> LL NECESSARY INFOR~ATI~ <br /> <br />F'LAN ~'~EVIEW." BY <br /> <br />RE~ARI(S: WATER L:J3'IE <br /> <br />QUANTITY AMOUNT <br /> $2,,50 <br /> <br /> ~1~0,, 00 <br />$52.50 <br /> <br />RE(:;EI Pl' NO: 54818 <br /> <br /> TYF'E." OK CHECK 4t: 858 <br /> <br />A REVIE~ PROCESS WHERE THE <br />~THE APPLICANT TO ASSURE THAT <br /> <br /> BY ...................... I)ATE <br /> <br />FO~M ~ MC ~-~ n~v..~ OF FICE COPY <br /> <br /> <br />