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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HJGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 888-5147 8:00 - 4:80 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> LUCA5, ROE)NEY <br />SITUS ADDRESS: <br /> <br />rIME: 10:.44:54 <br /> <br />TAX LOT <br /> <br />CONSTRUCTION TYPE <br /> <br /> 6?92 WJ,'IZ.~ ROAD SE <br />I URNER OR 9?392 <br /> <br />USE OF BUILDING: <br /> <br /> CONTRACT CITY: <br /> <br />~ARI ON OOUNTY <br /> <br />JGB: <br /> <br />MAIL NG ADDRESS. <br /> <br />5771 LIBERTY RO <br />SALE,N, OR <br />PHONE: 564-0528 <br /> <br />21 85 <br /> UNITS <br /> <br />1. B AC <br /> <br /> CATEGORY <br /> <br /> OCCUPANCY <br /> <br /> 2CCUPANT LOA£ <br /> <br />NU <br /> <br />SITE NU~4E~ER: <br />VALUATION: <br />RANGE ZONE <br /> <br />IRREG. ST: CORNER <br /> NO NC <br /> <br />RESIOEN/'Z~L <br /> <br />NO OF BEDROOMS <br /> <br />HAp. <br /> <br />TYPE: PLUMBING <br /> <br />PER14iI' OR APPLICATION NO; <br /> <br />CONTRAC'FOR, NO+ <br />LUCA.S, RODNEY <br />5771 LIBERTY RD <br />SALEM, OR 9?305 <br />PHONE: 364-0528 <br /> <br /> ITEM <br />~'f'ER LINES, 1ST 100 FEET <br />NA'T'ER LINES, FA. ADDL. 100 FEEl' <br />SE~ER LINES, 15'F 100 FEET <br />IvFOSILE HOf,,1E SE~ER AND ~ATER CONNECTiFAN <br />PLUfWSING STATE ~LIRr,.~rtARr, SE <br /> <br />33665 <br /> <br />QUAN'T'i'T'Y ANOUNI <br />~ $~o.oo <br />~ $~5.00 <br />I $30.00 <br />~ $25.oo <br /> $4.50 <br /> <br />PAYEE: <br />RECEIVEO BY: DM <br /> <br />TOTAL ~ED FEES <br />PRE~/i(~J$ RECEIPTS <br />THIS RECEIPT <br /> <br />$94.50 <br />$94.5o <br /> SO.OD <br /> <br />BALANCE C~JE $0.00 <br /> <br />RECEIPT NO: <br /> <br /> .................................... ,~ ............................................ TYPE: CHECK ~: 0 <br /> * THIS IS A VALID PER~IT * THIS PER,lIT EXPIRES 180:DAY~ FROM iTS I,~SUE DATE. ZF <br />CONSTRUCTION CEASE~ FOR A PERIOD OF180 DAY~, OR IF CONSTRUCTION FAiL.~ TO MEET ALL <br />~R1E~ALALIRI~IENTS OF STATE ~ ANDMARION COUNTY BUILOIN6 AND ZONING OROiN/~NCES. THIS PEF~I[T <br /> L BF_C~E NULL AND VOID+ <br /> <br />RE~RKS: rcH CON, WL,& SL R~6627 <br /> <br />[TJNALO E. WOODLEY, MARION CC'~JNI'Y BUILDING OFFICIAL / BY <br /> <br />PORM # MC 15-56 RSV. 4]~0 OFFICE COPY <br /> <br /> <br />