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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 />~ am performing work on a property I own or occupy. , <br />l am a registered builder OR ( )theautl~orizedrepresentative <br />of a registered builder, <br />The work wilt be performed by a reqistered btdlder. <br />Other_ <br /> <br />this document. <br /> <br /> ....................... l,A, <br /> <br /> 120 ERIN'" sr'"' <br /> DETROIT OR 9?342 <br />i~§~' 5'F-§-o~5 h~= oE'r ROi"f <br /> <br />MAILING ADDRESS: <br /> <br />4,505 SE LACREOLE DR ~106 <br />DALLAS 9?338 <br />f>HONE: 62,3-5910 <br /> <br />TYPE: ~ECHANiCAL PERMIT OR APPLiCA'fiON NO: <br /> <br />CONI'RACTOR, NO- <br />HENZEL, iRiS <br />4505 SE LACREOLE DR ~106 <br />DALLAS 9?338 <br />PHONE: 62~-5910 <br /> <br />OONES'f'IC W(,X~O STOVE <br />MECHANICAL BA~E FEE <br />MECHANICAL. SfA'f'E SUk-~ARGE <br /> <br />35837 <br /> <br />QUAN'I'i'T'Y <br /> 1 <br /> <br />$7.50 <br />$~o_oo <br />$0.88 <br /> <br />?HiSREO6i'P:T <br /> <br /> BALANCE DUE <br /> <br /> TYRE: iN <br /> <br /> $0,oo <br />$~8_38 <br /> <br />$o_oo <br /> <br />PAYEE; HfC,,:NZEL, IRIS iNVOiCE NO: 37752 <br />RECEIVED BY: gM2 CHECK ~: 0 <br /> <br /> * THiS .[,S A VALID PERI,lIT ::: TH.[,S. pEI:~4iT:. ~P.I:RBS 180 DA~:':!FRO~I iTS i.~FA.IE DATE. <br />C(~STRUCTION CEA..~E~ FOR A PER[oD 0'R 11= COIk~RI. JC'I'iON FAILS TO MEET ALL <br />~IREI~E~T:S OP 3TATE ~ ~D~:iI~IA~J. ON ORDINANCES., THIS PERI~11T <br />:,!SHALL BECO61E NULL AND VOID.::,::: ' : ,:: <br /> <br /> R~RK~.: EXiS'r'LNG hr5 <br /> DONALD E. VCOODLEY, Iv~RJ. ON C;CONT'Y BUiLBING OFFiCiAL/ BY .= ....................................... ~ <br /> <br /> <br />