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MARION COUNTY BUILDING INSPECTION <br />SENA'FOR BLDG, NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: .~88-5't47 8:00- 4;30 <br /> 2¢ HOUR CODE-A-PHONE: .588-7904 <br /> <br />I am a registerad builder OR ( ) ~he authoriz~ representative ~IGN~RE OF APPLICANT+ . <br /> <br />owner E: 02/26/91 <br /> <br /> ~, ~.~OHN.,T~3N, JiM <br /> <br /> 39872 O~'r~D RD N~ <br /> <br />DAY 6S2-2~;20 <br /> <br />~ C~N~TRUCT~O~J 'I'¥PE: 73350-0~0-87 OCOU,ANC~ <br /> <br />~,[TE NUI~ER: 530 <br /> <br />6 <br /> <br />PE~IlT OR APPLICATION NO: 9030628 <br /> <br />CONT~TOR, NO. <br /> <br /> 0AY 682-2420 <br />PHL.~E: 678-5133 <br /> <br />WATER ~,JPPLY: <br />TI~T HOL~ READY: <br />SiTE EVALUATION NUMBER: <br />EXISTIN~ TA'~K <br />~I~T1N~ D~IN FIELD LINE~: <br />~PTIC <br />PREVI~ NO. <br /> <br /> ITEM <br />AU1HORIZA~ION NOTICE - FLD. VI3iT <br /> <br />PAY6E: J~SON, JiM <br /> <br />TOTAL A.E~ED F~E~ <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />BALANCE CXJE <br /> <br /> C~JANTI[Y AA'IOUNF <br /> <br /> $105.00 <br /> $0,00 <br /> $~05.00 <br /> <br /> $0,00 <br /> <br />R~EiPT NO: 32355 <br />TYPE: CK CHECK ~: 339 <br /> <br /> RECEIVED ~Y: P8 <br /> <br /> ~E ATIACHED ~M~I~"[ FOR REQUIREMENTS OF I~-~I1"E ~i~A~E ~Y~I'~I~, <br />* ~IS 1~ ~T A ~iT. ~l~ ~[~Ti~ ~T ~ ~ A ~I~ ~ ~ THE <br />~LL~I~ ~T ~E ~ET~. IT 1S ~E ~IB~LI~ ~ THE ~PLI~T TO ~ T~T <br />ALL N~Y IN~TI~ ~ B~ ~iDED. <br /> <br />RP3WARKS: AUTh .r.<~5230 ~ <br /> <br />Fo~ ~,~c ~s~v v~ OFFICE COPY <br /> <br /> <br />