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MARION COUNTY BUILDING INSPECTION <br />SENATQR 8LDG, NO, c'25 <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 euthOrized teptesent~ltive <br />of a registered builder <br /> <br />OWN~S t)h E, ~,./~7/9'~ ~'~F_ ..... 4"?. ~8- TAX LOT CATI~CIORY <br />...AVALLF'E....J_0F!N_ ................................................. RES[DENT~L <br /> OCCURANCY'. <br /> <br /> 9493 W STAYTON RD -- <br />AUM!]VILLE OR 97325 <br /> <br /> CONSTRUCTION TYPE: <br /> <br /> 5~-u-~-~-f-~Xb~ ............. <br />~o~oi¥~ .... -u~-~- ........... <br /> <br /> SITE NUMBER: 73-04121 <br />PHONE: 749-1508 VALUATION: [ <br /> <br />TYPE: HECHAHICAL PERMIT OR APPLICATIONNO= 9851696 <br /> <br />CONTRACTOR, NO.. 48630 <br /> Willanette Woodstoves loc <br />1&95 Nmrket St. NE <br /> <br />PHONE~ 364-6339 <br /> <br /> ITEM <br />GAS CONNECTION <br />DOMESTIC WOOD STOVE <br />MECHANICAL BASE FEE <br />HECHAIq[CAL STATE SURC <br /> <br />PAYEE: <br />RECEIVED BY: MB <br /> <br /> Z THIS IS MOT A <br />FOLLOWING MUST i <br /> LL NECESSARY INFORNATI[ <br /> <br />PLAN REVIEW: BY <br />CITY JUR:[SDICTIO~-~?' <br />~EMARKS;; ~L~WS <br /> <br />QUANTITY AMOUNT <br />1 $2.00 <br />t $7.50 <br /> ~],0-00 <br /> $0.98 <br /> <br />$~0.48 <br /> <br /> $0.00 <br /> <br />$20.48 <br /> <br />RECEIPT NO: <br />TYPE: CHECK <br /> <br />PROCESS WHERE THE <br /> TO ASSU~E THAT <br /> <br />FORM # MC- '$.~ REV, 4/90 OF FICE COPY <br /> <br /> <br />