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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM, ~)REC,-~N 9'7301 <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONE 4:30 P,M, - 8:00 A.M. <br /> <br />I am performir~9 work on a property I own Or occupy. <br />lamare~lsteredbuilderOR( )theautflori~ePrepresentative <br />ct a re~listered builder, <br /> <br />o~F~: 10/30/87 TIME: 2:36:55p TAx t. OTz CATEGORY; <br /> <br /> JOHNSICK, GENE R <br />SITUS AOORE~S: i CONS'~'~U~TION TYPE[ i O~tJPANO¥: <br /> <br /> 13911 NISTERIA DRIVE NE CONTRAC~iTY; iO~B: i0~PANT LOAD: <br /> AURORA OR 97002 i ~ ~ <br />USE OF BUiLDiNG: ................. MAR-tON'-6E~INTy l.. NO ~ , NO o~ e6o~oo~s <br /> <br />MAILING ADORE~; SINGLE FAMILY DWELLINGS <br /> <br /> SAME <br /> <br /> PHONE: 67~-$764 <br /> <br />LOT: ~i.6CK: 'SECTioN: <br /> <br />WIDTH; :DEP~'N: AREAl <br /> <br />SITE NUMBER: 2979 <br /> VALUATION.: <br /> <br />TYPE: MECHANICAL <br /> <br />CONTRACTOR, NO. <br />JOHNSICK. GENE R <br />SAME <br /> <br />PHONE: 678-$764 <br /> <br />PERMIT OR APPLICATION NO: 5319 <br /> <br /> ITEN <br />DOMESTIC I,¢3OD STOVE <br />MEONANICAL SASE FEE <br />FLEET SURCHAROE -zONE 6 <br />NEC~IANICAL STATE SURCHARGE <br /> <br />PAYEE: JOHNSICK, GENE <br /> <br />QUANTITY AMOUNT <br /> 1 $?.50 <br /> $10.00 <br /> $7.68 <br /> $0.88 <br /> <br /> TOTAL ~E:~,SED ,FEE~ <br /> PREVIOUS RECEIPTS <br /> THIS RECEIPT <br />.DANCE DUE <br /> RF2CEI PT NO; <br /> <br />$26.06 <br /> $0.00 <br />$26.0~ <br /> <br />$0.00 <br /> <br />5376 <br /> <br />RECEIVED BY: CL . TYPE:': C~::': CHECK ~: 1266 <br /> <br />~ THIS IS A VALID PERMIT * THIS F~ ~ I~E ~TE. IF <br /> <br />~ BE~ NU~ ~D ~ID. ' <br /> <br />REMARKS.* ~ <br /> <br />CONALD E- WOOOLEY, tcI'*.RION C.C~NTY BUILDING OFFICIAL /'D:y ........................ <br /> <br />OFFICECOPY <br /> <br /> <br />