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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br /> 24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am a registered builder OR ( ) the authorized representative SIGNATURE OF APPLICANI: <br />of a registered builder. <br />The work will be performed by a registered builder. <br /> <br />I have read and agree to the terms stated on the reverse side of 0ATE~ <br />this document <br /> <br /> DATE: 05/31/91 TIME: <br />SITUS ADORES 'S~iNDLE~.' iVF..]'4 <br /> <br />8:12:45 <br /> <br />TAX LOT: <br /> <br />CONSTRUCTION TYPF~: <br /> <br />: CONTRACT CITY; <br /> <br />~'~A~:.~ ~ (.'{~N I Y <br /> <br /> SUBDI¥1SION: <br /> <br /> CATEGORY: <br /> <br />NO <br /> <br />SAME <br /> <br />SECTION: I~OWNEHIP: , ~ NUMBER;: ZONE~ 2256 MAR; <br /> VALUATION: <br /> <br /> UNITS: IRREG. LOT: CORNER: <br /> 13 8~ 2W AR3 49 R <br /> <br />2.5 AC NO NO <br /> <br />'TYPE: PLUf~iNO <br /> <br />PEI. b'~lIl' OR APPLICAI'iON NO: 32587 <br /> <br />CON'FRACTOR, NO. 45532 <br />KIDD PLUI'4BING <br />543 EUREKA AVE <br />SILVER'fON, ORE6.vC~ 97381-2225 <br />PHONE: 873-5103 <br /> <br /> 1TEM <br />RE..~iDEN'f'IAL FIXTURE, ALTERATIONS <br />PLUMING BASE FEE <br />PLUMBING STATE SURCHARGE <br /> <br />QUANTITY AJ'4OUN'i' <br /> 4 $36.00 <br /> $20.00 <br /> $2.80 <br /> <br />TOTAL ~ED FEES <br />PRE~'iO~ISRECEI~TS <br />')'HIS RECEIPT <br /> <br />$58.80 <br /> $0_00 <br />$58.80 <br /> <br />BALANCE DUE $0.00 <br /> <br />PAYEE: RECEIPI' NO: 34384 <br />RECEIVED BY: P8 TYPE~ CHECK ~: 5523 <br /> <br /> THIS i~ A VALID PEr, liT * TH,]..~ PERNIT EXPIRES 180 DAY~ PR(~ IT~ I~:~.JE DATE. IF <br />CI3N~TRUCT[ON C~ FOR A PERIOD OF 180 DAY~,, OR IF CONSTRUCTION FAIL~ TO ~EET ALL <br />I~-~UIRE~E~T8 OF STATE ~ /~ID f4ARi(~4 C~UNTY BUiLOIN6 ~D ZONING ORDIN~J'~ICE~, THIS <br />~ALL BEC(~IE NULL ~D VOID. <br /> <br />REMARKS~ 4 FIX R1*5523 <br />OONALD E. NOODLEY, f4ARiON COUNTY BUILDING OFFICIAL / BY .................................................... ..~_.._ ...................................... <br /> <br /> OFFICE COPY <br />~ORM # MC 15-~ REV, 4/9o <br /> <br /> <br />