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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 performln9 work on a property ~ own or occupy. <br />I am a registered builder OR ( ) the Authorized representative SIGNATURE OF APPLICANT; <br />of a registered builder, <br />The work will be performed by A registered builder. <br />Other ................. <br />I l~sue read arid agree to the terms stated on the reverse side of DATE: <br />this document. <br /> <br />DATE: 08/02/91 'fiNE: 14:02:4g <br />OWNER. raw LOW i CATEGORY' <br /> ALLENBY. THOMAS - 4024'7-000 i RESIDENTIAL <br />SITUS ADDRESS CONSTRUCTION TYPE: ' 0D~uPA~cY ' <br /> <br />10378 CHAIVlPOEG ROAD NE CONTRAC~C~Y UGB: 'OCCUPANf'LOAO: <br />AURORA OR 9?002 <br /> ............ IvtcN~tE)N CQUNT'.Y NO <br />US~ OF BUILDING: ]~ <br /> <br />MA~LING ADDRESS SUBD VISION <br /> <br /> PHONE: 5'78.-225B SiTE NUMB,~R: 4865 <br /> VALUA'r iON: <br />[OT SLOCI' SECTION TOWNSH P: RANGE ZONE: I M'A~: <br /> <br /> 6 4~ 1 W 4 EPU , <br />WiOTH DEPTH AREA UNITS IRREG LOT CORNER: <br /> o. AC; YES' NO <br /> <br />f'YPE; PLUIV~ i NG <br /> <br />PERMIT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. <br />CANDY PLUIVlD I NG <br />005 Nb: <br />CANDY, OREGON <br />PHONE: 266~-2091 <br /> <br /> if'EM <br />RESiOEN'f'iAL FIXTURE, AL'rERA'f'ION~ <br />PLUMBING BA~E FEE <br />PLUMBING 5'f'A'f'E SURCHAF:Y, JE <br /> <br />PAYEE: THOMAS H_ ALLENBY <br /> <br />34206 <br /> <br />TOTAL A~SE~ED FEES <br />PRb:WiOUS RECEJP'rs <br />l'HIS RECEIPT <br /> <br />QUANI'iT'Y ,AJ'4OUN'f' <br /> 3 $27,00 <br /> $20.00 <br /> $2_35 <br /> <br />$49,35 <br /> $0.0o <br /> <br />BALANCE DUE $0.00 <br /> <br />RECEIPI NO: 3607? <br /> <br /> RECEIVED BY: OM2 'fYPE: CK CHECK ~: 3107 <br /> <br />~ THIS 15 A VALID PEI;~liT ~ THISPERt4iT ED(PIRES 180 DAYS FRO¢,I iTS [,~E~JE BATE. IF <br />CONSTRUCTION CE.A..~E~ FOR A PERIOD OF 180 BAYS, OR iF CONSTRUCTION FAII..~ TO ~EET ALL <br />REQU[RErflENT$ OF ~TATE ~ AND FIA~1ON COUNTY 8UILOIN6 AND ZONING ORDINANCES, THIS PERi,liT <br />,~"IALL BECOME NULL AND VO[B. <br /> <br />REMARKS: 3 FIX R~3282 ~ <br />DONALD g. WOODLEY, MARION cOUNTY BUiLDiNG OFPiCIAL / BY ........................................................................................... I~ <br /> <br /> <br />