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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO. 228 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONE 4:30 P,M. - 8:00 A,M, <br /> <br /> I am performing work on a property I own or occudy. <br /> I am a registered builder OR the authorized represen at ye <br /> of a registerod builder. <br /> The work will be performed by a registered builder. <br /> Other__ <br /> I have read end agree to the terms stated on the reverse side of <br /> th~s document. <br /> 0ATE: 04/21/87 TIME: 12.'26:57p <br /> <br />OWNER' SAND,STRUM, EE.~AR _. <br /> <br />TAX LOT <br /> <br />: CATEGORY; <br /> <br />SITUS ADDRESS: <br /> <br /> 5577 DUIVlORE DR <br /> AUI~VI LLE <br /> <br />OR 9?325 <br /> <br />USE OF BL~ILDING: <br /> ONE AND T~O FA~IILY E)NELLINGS <br />MAILING ADDRESS' <br />SAME <br /> <br /> PHONE ¢ 364-6731 <br /> <br />CONSTRUCTION TYPE: <br /> <br />CONTRACT CfTY <br /> ~1C <br /> <br />SUBDIVISION: <br /> <br />SITE NUMBER: <br /> VALUATION: <br /> <br />1107 <br /> <br />LOT BLOCK SECTtON <br /> <br />WIDTH; DEPTH. AREA UNITS <br /> <br />TYPE: mECHANICAL <br /> <br />CONTRACTOR, NO. <br />~ANDSTRUm, EDGAR J, <br />SAmE <br /> <br />PHONE: 364-673t <br /> <br /> TOWNSHIP; RANGE: ZONE' MAP: <br /> I3 88 2~ AR3 49 <br /> <br />~ERHIT OR APPLIC~'tI'O~ NO- <br />. 1827 <br /> <br /> ITEM <br />DOM IEx~ST FANS & DRYER VENTS <br />MECHANICAL SASE FEE <br />FLEET SURCHARGE -ZONE 3 <br />MECHANICAL STATE SURCHARGE <br /> <br />TOTAL ASSE~ED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />QUANTITY AFC3UNT <br /> 3 $9.00 <br /> $10.O0 <br /> ¢3.84 <br /> 0.76 <br /> <br />223.60 <br /> 23;80 <br /> $0.00 <br /> <br />8ALAC4CE DUE $0.00 <br /> <br />PAYEE: INVOICE NO: <br />RECEIVED BY: P8 TYPE: CHECK <br /> <br />* THIS IS A VALID PEI~IIT * THIS DAYS FRO~I ITS ISSUE DATE. IF <br />CONSTF~CTION CEASES FOR A PERIOD FAILS TO MEET ALL <br />REQ~JIREHENTS OF STATE INNS ~J~D ZONING ORDINANCES, THIS PERf4IT <br />SHALL BECOME NULL AND VOID_ <br /> <br />REMARKS: MECH 2545 <br /> <br />DONALD E- NOOOt. EY. NLARION <br /> <br />OFFICE COPY <br /> <br /> <br />