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g§'/05/28 10:01 FAX: P.O01 <br /> <br />DATE/lINC <br />TYPk <br /> <br />W~RK DESC <br /> <br />Srl'F ADDRESS <br /> <br />TAX ACCOUN] <br /> <br />APPLICANT <br />ADDRESS <br /> <br />PHONE <br /> <br />CONTRACTOR <br />PH(')NF <br /> <br />PLU~BLR <br /> PHONE <br /> <br /> PI U~81NG APl"[ ICATION <br />: 05/19/99 11:25 ACTIVIIY NO <br />: Collml~rcial addiL~on/alteration S1AIUS <br /> APIILIED <br /> I(] FXPTRF <br /> <br />99 03026 <br />APPLIED <br />05/19/1999 <br />11/15/1999 <br /> <br />lOOF'r SI & WAILR METER <br /> <br />LUCAIOR: 041WU'JI.XX)O?OO <br /> CITY: MARION COUNTY <br /> <br />12184 [HLLN RD NF AR <br /> <br />40331-477 <br /> <br />IUTZ J£TTL IN£ <br />16928 SW BFFF BEND RD <br /> <br />OWNER: RIND BRAIN/P~(TS & CAR SAIFS <br />PHONF: 678-5599 <br /> <br />SHERWOOD. OR 97140 <br />590-7521 <br /> <br />LU1Z ,]E1-FE INC <br />590-7521 OCCB: 0089685 <br /> <br />LICFNSL: <br /> <br />Units Ooscr'iptlon FL~ <br /> 1 'l~mhing base Fee 25.00 <br /> 100 Feet sower tine charge 35.00 <br /> 1 Law{ vacuum breakers 7,50 <br /> 1 State surchargo 3.28 <br /> 1 Rurund .00 <br /> <br /> Assess~d 'fe~ ; /O.R8 <br /> Adjus~nts : 00 <br /> 'lotal fees : 70.88 <br />PAYEb: LUTZ JETTE INC Total payments: 70.88 <br /> Bal ante due : , O0 <br /> <br />Tills lS MDT A PERMIT, IT IS II1[ RFSPONSIBILIIY 01- I'HE APPLICA~Ir I0 ASSURE <br />Ii-~TALL. NFCFSSARY INFOR,AI.f(]N IS PROVIDLDAND. zFFES PAIDUEFORFAPERMII'MAY <br />BE ISSUED, ~.~2 _ J <br />SIGNAT~[ Om APPLICANT:/ ~,~'/~'~'~'~'~Y'/'¢"~'-~-7 ..~ <br />OONALD E. WgODLEY, MARION COUNTY BUILDING OFFICIAL / NY MBULL <br /> <br /> Marion C~nty Building Inspecti~ <br /> 3150 Lancaater Dr, N,E., Suite C Sal~, Ore~n 97305-1398 <br />Office Hours: B:00-4:30 Ph~e: (503)588-5147 24-hr Inspection Line: (503)373-4427 <br /> <br /> <br />