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DATE/TIME <br />TYPE <br /> <br /> PLUMBING APPLICATION <br />07/23/99 t4:40 ACTIVITY NO <br />Resident. addition/alteration STATUS <br /> APPLIED <br /> TO EXPIRE <br /> <br />99-05974 <br />APPLIED <br />07/23/1999 <br />01/19/2000 <br /> <br />WORK DESC <br /> <br />SITE ADDRESS <br /> <br />TAX ACCOUNT <br /> <br />APPLICANT <br />ADDRESS <br /> <br /> PHONE <br /> <br />CONTRACTOR <br />PHONE <br /> <br />PLUMBER <br /> PHONE <br /> <br /> LOCAIOR: 1DbEO1BCD41DO <br />4 FIXT, 20'WL, 20'SL-CHG STORAGE BLDG TO BATHROOM CITY: DETROIT <br /> <br />130 TUMBLE ST DT <br /> <br />90222-540 <br /> <br />USSELMAN.MICHEAL SCO~ <br />4046 NE CULLY BLVD <br />PORTLAND, OR <br /> <br />OWNER: USSELMAN,MICHEAL SCOTT <br />PHONE: <br /> <br />97212 <br /> <br />OCCB: <br /> <br />LICENSE: <br /> <br />Units Description Fee <br />1 Plumbing base fee 25.00 <br />4 Fixture alterations 60,00 <br />lO0 Feet water line charge 25,00 <br />100 Feet sewer line charge 35.00 <br />1 State surcharge 10.15 <br />1 Refund .00 <br /> <br /> Assessed fees 155.15 <br /> Adjustments ,00 <br /> Total fees 155,15 <br />PAYEE: USSELMAN,MICHEAL SCO~ Total payments: ,00 <br /> Balance due : 155,15 <br /> <br />THIS IS NOT A PERMIT, IT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE <br />TFUNT ALL NECESSARY INFORMATION IS PROVIDED AND FEES PAID BEFORE A PERMIT MAY <br />BE ISSUED. <br /> <br />SIGNATURE OF APPLICANT: <br /> <br />DONALD E. WOODLEY, PUNRION COUNI~/ BUILDING OFFICIAL / BY PMUNRO <br /> <br /> Marion County Building Inspection <br /> 3150 Lancaster Dr. N.E., Suite C Salem, Oregon 97305-1398 <br />Office Hours: 8:00-4:30 Phone: (503)588-5147 24-hr Inspection Line: (503)373-4427 <br /> <br /> <br />