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MARION COUNTY BUILDING INSPECTION
<br />SENATOR BLDG. NO. 225
<br />':;'20 HIGH STREET NE
<br /> SALEM, OREGON 97301
<br />
<br /> PHONE 588-5147
<br />CODE-A-PHONE 4:30 RM. - 8:00 A,M.
<br />
<br />I em performing work on a property I own or occupy,
<br />I am a registered Builder OR ( ) the authorized representative
<br />
<br />DATE: 09/13/89 TIME: 8:48:57a
<br />
<br /> RIOHAROS, ~!AYSEL
<br />
<br />BIGNATURE OF APPLICANT:
<br />
<br /> BATE'
<br />
<br />TAX LOT:
<br />
<br />CONSTRUCTION TYPE;
<br />
<br />CATEGORY'
<br />
<br />OCCUPANCY:
<br />
<br /> 285 CLEVELAND STREET
<br />~'43V.~ LLE OR
<br />
<br />USE OF BUILDING:
<br />
<br />97325
<br />
<br />CONTRACT CI~Y: UGB;
<br />AL',N~V I LLE
<br />
<br />MAILING ADDREBS:
<br />
<br />SUBDIVISION:
<br />
<br />,r4') ,.cc.,' )X 108
<br />AL.IM,£ ¢: LhE OR 97325
<br />PHONE: 749-26:6
<br />
<br />8S
<br />
<br /> S,~TE NL!MSER:
<br /> VALUAT ! ON:
<br />RANGE:
<br />
<br />IRREG LOT:
<br /> NO
<br />
<br />ODCUPAN"f' LOAB:
<br />
<br /> NO. OF BEDROOMS:
<br />
<br />ZONE: MAP'
<br />
<br />CORNER:
<br />
<br /> NO
<br />
<br />TYPE: MECHANICAL PERMIT OR APPLICATION NO:
<br />
<br />MARK ,'°RESC~T?
<br />'? ~ E~,S''r' POWELL
<br />?4()N MC;)( J TH 0 R 9 ? 3 6 ]
<br />
<br />DOM EXHST FANS & DRYER ENd'S
<br />VECBiNN?,AL BASE FEE
<br />FLEET SURCHARGE -ZONE B
<br />,v'f{'C.,,Al'g[OA~ STATE SURCHARGE
<br />
<br />TOTAL ASSESSED FEES
<br />PREVIOUS RECEImT6
<br />THIS RECEPT
<br />
<br />QL AR. T ! %v .~- ¢/'Ot, IN T
<br /> 2 $8,0C
<br /> $'0.0:7,
<br /> $3.84
<br />
<br />$20 5{
<br />$2O.Sq
<br />
<br />BALANCE 'DL E ,',.'
<br />
<br />pAYeE - ,s"; ', INVOI.C,.'E NOt
<br />c;,~',",'r-~-'f/.p'-n pr, p~ , TYPP",,',' 'CHECK ~.:
<br />
<br />THiS IS A VALID PE~IT ~' ~,IS,'~PE~IT ~PIRES t80 ~Y~':'F~ ITS ISlE DATE_ IF
<br />~ST~CTION C~S~ FOR A ,P~tOD,',~,~0.,,~~, OR, ~,E,,~S~I~ FALLS TO ME~ ALLpERMIT
<br />REdIReCTS OF STATE ~ ~D ~:~ ~N~BUI~D~NG ~D:'Z~ING ORDIN~CES, THIS
<br />~ALL BE~NE NULL ~D VOID,. .... ,,,,, , ..... ., ',,, ; ',~,
<br />
<br /> b. ,ARK.~: FN
<br /> 3.)NALD E. ~OOOLETM, ~ARION COLNTY BUiLD;NG OCFiCIAL /BY .....
<br />
<br />OFFICE COPY
<br />
<br />
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