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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO. 225 <br />2:)0 HIGH STREI::T NE <br /> SALEM, OREGON 97;301 <br /> <br /> PHONE: 588.5147 8:00.4:30 <br />24 HOUR CODE-A-PHONE: 588.7904 <br /> <br />~[~NATgRE OF APPLICANT: .................................. <br /> DATE', ....................... <br /> <br />PHCe,tE: 581-1872 SITE NUI~ER: 3193 <br /> .......... , -VAU_t A-T ~: ............... <br /> <br /> I <br /> <br />29654- <br /> <br /> J[TEM <br />ANNUAL EWAL. - T~I~ OR H[:~-IP ~1 <br /> <br /> .mS,s ss o, <br />TH%'~ RE,CE I' PT <br /> <br />qUANTITY <br /> <br /> ,~T <br /> -$6o.oo <br /> <br /> -$60.00 <br /> $o.oo <br /> -$60,00 <br /> <br /> $o.oo <br />~1~26 <br /> <br />REMAR[,~: 'REFUND OF' PE'I~IT. 29480 <br /> <br />ro~M. ~ ~;.~ n~.'..u~ OFFICE COPY <br /> <br /> <br />