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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 <br />OODE-A-PHQ~5~E 4;30 P,M. - 8;00 A.M. <br /> <br />of a registered builder. <br /> <br />Other <br /> <br />SIGNATURE OF APPLICANT: <br /> DATE~ <br /> <br />~ Ol/23/9o <br /> <br /> DORAN, TON <br /> <br />SUBLIMITY <br /> <br />'FINE: 11:02:t0 <br /> TAX LOT; CAYEGOR¥; <br /> <br /> RESIDENTIAL <br /> ,5-/,5- 6r,¢¢ <br />OR 9?285 <br /> S~I,,,-I,M,I, TY ............... NO : NO <br /> <br />PO BOX 185 <br />,.~BLIMITY OR 97383 <br />PHONEt 789-7364 <br /> <br />WlDT~7 ]:>EpTH:1 <br /> 81 100 <br /> <br />MORNING CREST ADD III <br /> <br /> SITE NUMBER: 9160 <br /> ~ALUATION: <br /> <br />~4 ;UNITS; 8S , ~RREG. ~0~ CORNER: <br />8!00 SE NO i YES, <br /> <br />MAP: <br /> <br /> 4? <br /> <br />TYPE: MECHANICAL PERMIT OR APPLICATION NO~ <br /> <br />CONTRACTOR, NO. 55493 <br />TON DORAN <br />PO BOX 185 <br />SUBLIMITY 97385 <br />PHONE: 769-7364 <br /> <br /> ITEN <br />GAS CONNECTION <br />FORC AIR FURN 100000 BTU OR LESS <br />DOvlESTIC RANGE HOOD <br />DON EXHST FANS & DRYER VENTS <br />MECHANICAL SASE FEE <br />FLEET SURCHARGE -ZONE 4 <br />MECHANICAL STATE SURCHARGE <br /> <br />PAYEE: TOM DOP. AN <br /> <br />21454 <br /> <br /> TOTAL ASSEE~ED FEES <br />PREVIOUS :RECEIPTS <br />THISRECEIPT <br /> <br />QUANTITY AHOUNT <br />1 $2.00 <br />1 $6.00 <br />1 $4.50 <br />4 $12_00 <br /> $10.00 <br /> ~5.12 <br /> 1.73 <br /> <br />$41.35 <br /> $0.00 <br />$41.35 <br /> <br />BALANCE CUE $0.00 <br /> <br />INVOICE NO; 22?54 <br /> <br /> RECEIVED BY: P~ TYPE: IN CHECK ~: 0 <br /> <br /> * THIS IS A VALID PERMIT ~ THIS PERMIT EXPIRES 180 DAYS FRON :ITS ISSUE DATE. IF <br />CONSTRUCTION CEASES FO~ A PERIOD OF 180 DAYS, OR IF ~CTION FAILS TO MEET ALL <br />~R~Q~IRE~E~TS OF STATE ~ AND I~ARION COUNTY 8UILDING:AND ZC~NIN6 ORDINANCES, THIS PERNIT <br /> L BSCONE NULL AND VOID. <br /> <br />RBVlARKS: GS FUF~N HO FN <br /> <br />DONALD E, NOODLEY, MARION COUNTY BUILDING OFFICIAL / BY' <br /> <br />FORM ~f MC 15'51~ RI?V ~m~ OFFICE COPY <br /> <br /> <br />