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MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> <br /> 285 Church Street NE · Room 132 · Salem, Oregon 97301-3670 <br />Office Hours: 8:00-4:30 · Phone: (503) 588-5147 · 2A-HR Inspection Line: (503) 373-4427 <br /> <br /> PLUHBIN~ APPLICATION <br />DATE/TIHE : R4/ID/?7 15=28 ~CTIVITY HO : 97-~2556 <br />TYPE : Resident. addition/alteration STATUS : APPLIED <br />OCCUP/~ICY : U-1 N~PLIED : <br /> TO EXPIRE : <br /> <br />WORK DESC : 2/FIX WL SL <br /> <br />SITE ADDRESS <br />CROSS STREET <br /> <br />PARCEL NUMBER <br />OWNER NAME <br /> <br />APPLICANT <br /> NAME <br /> ADDRESS <br /> <br /> PHONE <br /> <br />CONTRACTOR <br />PHONE <br /> <br />PLUMBER <br /> PHONE <br /> <br /> Units <br /> 1 <br /> 2 <br /> <br /> 108 <br /> 1 <br /> 1 <br /> <br />13581CEDARWOOB RD NE AR <br />BOONESFERRY <br /> <br />48482-088 <br />MEDICA~CARLOS <br /> <br />ME~ICA. CARLOS <br />13,~81CEDARWOOD RD NE <br />AURORA~ OR <br /> <br />678-6257 <br /> <br />MEDICA, CARLOS <br /> <br />CITY: MARION COUNTY <br /> <br />97882 <br /> <br />OCCB: <br /> <br /> LICENSE: <br /> <br />Description F,e <br />PluMbing base fee <br />Fixture alterations 28.88 <br />Feet water line charge 28.88 <br />Feet sewer line charge 38.88 <br />State surcharge 4.58 <br />Refund <br /> <br />Assessed fees : 94.58 <br />Adjustments : <br />Total fees : 94.50 <br />PAYEE: MEDICA, CARLOS Total payments: <br />Balance ue : 94.58 <br /> <br />THIS IS HOT A PERHIT. IT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE <br />THAT ALL NECESSARY IHFORHATION IS PRDVIDE~ AND FEES PAID bEFORE ~ PERHIT HAY <br />RE ISSUE]). <br /> <br />SIGNATURE OF APPLICANT: ........................ <br /> <br />DONAL~ E. WOODLEY, MARION COUNTY BUILDING OFFICIAL / BY MBULL <br />................................. FOR OFFICE USE ONLY ...................... <br /> <br /> MAP: ZONE: EFU PROPERTY LOCATOR: 041Wll 88408 <br /> <br /> PLAN REVIEW: DATE: ZONING REVIEW: DATE: <br /> <br /> <br />