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MARION COUNTY BUILDING INSPECTION <br /> <br /> 3150 Lancaster Dr. N.E. · Suite C *Salem, Oregon 97305-139~ <br />Office Hours: 8:00-4:30 - Phone: IS03) 588-5147 * 24-HR Inspection Line: (503) 373-4427 <br /> <br />: 97-S4157 <br />-- ISSUED <br /> <br />: 12/e2/1997 <br /> <br />WORK D;~C ..... T-C~-E~R;~FC~OR-R£~TER ...................................... <br /> <br />SITE ADDRESS : <br /> <br />CITY: MARION COUNTY <br /> <br />CROSS STREET <br /> <br />PARCEL NUMBER <br /> <br /> 13791 WISTERIA DR NE AR <br />WEST OF AIRPORT <br />718~0-220 <br /> <br />OWNER NAME : JEWKES,EVELYN <br /> <br />APPLICANT <br /> NAME <br /> ADDRESS <br /> <br />PHONE <br /> <br />CONTRACTOR <br />PHONE <br /> <br />FIRESIDE DISTRIBUTORS OF ORE~ON <br />18389 SW BOONES FERRY RD <br /> <br /> PORTLAND, OR 97224 <br />: 684-8535 <br /> <br />FIRESIDE DISTRIBUTORS OF OREGON <br />684-8535 <br /> <br />LOCATOR: 041WllCA00500 <br /> ZONE: AR <br /> <br />OCCB: 0B40979 <br /> <br />Unit~ Descriptiop Fee <br /> ~ase <br /> 1 Floor nounted heaters 6.00 <br /> I Gas outlets <br /> 1 State surcharge .?8 <br /> 1 Refund <br /> <br />Assessed fees : 18.98 <br />Adjustments : .~0 <br />Total fees : 18.98 <br />PAYFE: FIRESIDE DISTRIBUTORS OF OREE-ON Total payments: 18.98 <br />Balance due : .00 <br /> <br />THIS PERNIT IS NON-_TRANSFERABLE ~D EXPIRES 10S I~Y8 FRBN ISSUE DATE IF UDRK H~ <br />~iTTE#O .14EET ~L REGUIREI4ENT~ OF ~T~TE L~#5 AND HARION COtMTY OR~IN~d4CES. UPOH <br /> RESUEI~T, GNEBIX (&) ~ EXTENGION HAY BE GR~ITE~. <br /> <br />SIGNATURE OF APPLICANT: <br /> <br />DONALD E WOODLEY, MARION COUNTY BUILDING OFFICIAL / BY HBULL <br /> <br /> <br />