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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO. 225 <br />220 HIGH STREET NE <br /> SALEM. OREGON 9~301 <br /> <br /> PHONE: 588~5147 8:00- 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />i'oWNBArE- <br /> <br /> situs ADOR~S~.~'[U'~j[C, R(,JBER'I' <br /> <br />iME: 1~20248 <br /> <br />TAX LOT iCATEGORY' <br />CONSTRUCTION TYPE OCCUPANCY <br /> <br />BEN 'l' i .AL <br /> <br /> 2~0 CENTER S'f'REE'r <br />DE' 'ROi f' ..... <br /> <br />OR ~Z2¢2 <br /> <br />O~']'~>~lI'l NO NO 0P BEDROOMS <br /> <br /> PO BOX 583 <br /> 0Ef'ROi'T <br /> PHONE: 854-34?5 <br />LOT: BLOCK: <br /> <br />SECTION TOWNSHIP: <br /> <br />SiTE NUMEgR: 1163 <br />RAN~ALUA'T iON: ~ON6 MAP <br /> <br />, 1 ('l(l ? ? <br /> <br />.... :, 770~, <br /> <br />105 <br /> <br />fYPE: MECHAN I CAL, <br /> <br />CONTRACIOR, NO. <br />:~,.~lC, ROSERI <br />PO BOX 583 <br />QET'~)II <br />PHON~: 854~3~75 <br /> <br /> II'EM <br />O(,.~ES['iC WOOD 5'lOVE <br />~CHANiCAL BASE FEE <br />MECHANICAL ~'I'ATE SURCHARGE <br /> <br />PAYEE,: CciJSiC, K~SER'I" <br />RECEIVED BY: DM2 <br /> <br />PERMIT OR APPLiCArION NO: <br /> <br />35?99 <br /> <br />iJUAN f' 'Y <br /> 1 <br /> <br />TOTAbASSE~EO FEES <br /> PREVIL~JS RECEIPTS <br /> THI'SRECEiP'I' <br /> <br /> BALANCE DUE <br /> <br /> INVOICE NO: <br />'fYPE: iN CHECK <br /> <br />AMOUNI' <br /> $7,5o <br /> $~8-0~ <br /> SD.aa <br /> <br /> $18.38 <br /> <br /> $1$.:ss <br /> <br />* THiS IS A VALID P~R~IlT * THIS PER~fliT EXPIRE,S 180 l~l~ FROf8 ITS I,~E DATE. IF <br />O61~STRUCTi~ 6~B F~R A' ~RIOD OF 180 ~YS, OR IF CONSTBOTION FAI~ TO MEET ALL <br />REQUIREtflENIS OF STATE L~ ~lD I~ARION COUNTY BUILDING ANO ZONING ORDINANCES, THiS PEi~IIT <br />SHALL BECOME NULL AND VOID. <br /> <br />REMARKS: EXi3'f'ING WS -"'~'""'"' <br />£×)NAL. B g. I,¢JOOLEY, MARION C©UN'T'Y BUILDING OF'FIGiAL / 8Y....;~. ................. <br /> <br />~o~M # uc ~-~e RaY. ,~o OFFICE COPY <br /> <br /> <br />