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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 />lamaregisteredbullderOR( )theauthorizedrepre~entative <br /> <br /> ~iTU~ ~¢~!~h'~ I)AI:I, i CONSTRUCTION TYPE; OO~t~PANCY <br /> <br /> J. 368{~ ~IS'TERtA ~R NE ~ <br />iUSE OF BUILDING: !NO OF BEDROOMS: <br /> <br />ADDRESS; SUBDIVISION: <br /> <br />SITE NUHBER: <br />VALUATION: <br /> <br />WIDTH; I~E~H'. AREA; [ UNIT~; ~ IRREG. LOT: [CORNER; <br /> ! ~ .................... ~_j i--~0 ~.-- ~t~ <br /> <br />TYPE= HECH~NICAL <br /> <br />C~!NI'RA,IT;TOR~ FIB, J, 4008 <br />Rotl), Zachery i,,leati~lq <br />59] SE lst' Ave - <br /> <br />GAS CONNEC'I'~ON <br />F'OR6 AIR F'U~NACE UIqDE~ <br />GAS WATER HEATER <br />NF. CHANICAL BASE FEE <br />HECHAHICAL S'rAI'E SURC~ <br /> <br />PAYEE':: Ro~M Zacher'y <br />RECEIVED BY~ I';b ': <br /> <br />PER~IT OR APPLICATION HO: &11~8 <br /> <br /> ~ THIS IS A VALID <br />COHSTEUCTTOH CEASES FOR: <br /> E[IU~REHEHTS OF STATE <br /> ALL BECGHE HULl., AH9 , <br /> <br /> .OfIF~¢,i.D [,, WO~:iD[,~Y~ ~AI:~:~ON COL~NI:Y BUILDI'N[;,OFT'ZC~AL / BY <br /> <br />T Y A M 0 U N '¥' <br /> <br />,I, $& ,, 0¢ <br />1 $7,, 50 <br /> <br /> $1 ,, 28 <br /> <br />$ 2 ~:) ,, 78 <br /> <br /> RECEIF"f' NO: ,57~773 <br />TYPE: CK CHECK :t~; 8714 <br /> <br /> EROM ITS ISSUE ~ATE. IF <br />FAILS TO MEET ALL <br />Z~NiNG ORDIHANCES~ THIS PERMIT <br /> <br /> OFFICE COPY <br />FORM # MC 15.56 REV. 44'90 <br /> <br /> <br />