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MARION COUNTY,RUIL'DING INSPECTION <br />SENATOFCqBLDG, NO. 225 <br />220 HIG'H STREET NE <br /> SALEM, OREG(~N 97301 <br /> <br /> . PhONe 583-5147 <br />CODE-A-PHONE 4:30 P.M. - 8:00 A.M: : <br /> <br /> I am performk)g work on a property I own or occupy. <br /> lama registered builderOR( ) the authorized representative <br /> of a registered builder, <br /> <br /> Other ..... <br /> <br />DATE: 10/07/39 ~T.]EME= 11:03:19a <br />~NER: <br /> HAN, THOf4AS <br />~TUS' ^~b'~'ss ............................. <br /> <br /> 90222-110 F~ES)'DENTIAL - <br />CONSTRUCTION TYPE OCCUPANCY: <br /> <br /> 330 BC/JLDER <br /> DETROIT <br />~'~1-~¥ 0 ~ BU Il ~)li~G" ............................ <br /> <br />1990 NAPLE AVE NE <br />SALEM 97303 <br />PHONE: 581-1885 <br /> <br />OR <br /> 9?342 <br /> ... DrROI.~ ................ !i .__.. N,o,, ................ {. ".__z.;: " <br /> <br /> SUBDIVISION: <br /> H~'fC2N D ADDN <br /> <br />SITE NUMBER: 5692 <br />VALUATION.+ <br /> <br />TYPE.+ MECHANICAL PERMIT OR APPLICATION NO: 9011702 <br /> <br />CONTRACTOR. NO. <br />HAN, THOMAS <br />1990 MAPLE AVE NE <br />,'SALEM 9?303 <br />PHONE: 581-1885 <br /> <br /> ITEM <br />[~TIC WOOD STOVE <br />MECHANICAL BA~.SE FEE <br />FLEET ,?~JRCHARGE -ZONE ? <br />MECHANICAL STATE SURCHARGE <br /> <br />PAYEE: HAN, THOMAS <br />RECEIVED BY: dm <br /> <br />~ THIS IS NOT A PERNIT. <br />FOLI_Ok~ING le~JST BE CQNPL~r~D.' <br />ALL NECESSARY ZNFORMATIONHA~ <br /> <br />QUANTITY ANOUNT <br /> I <br /> $10.00 <br /> $8.96 <br /> $0.88 <br /> <br />NO: <br /> <br />$2?.34 <br /> $0.00 <br /> <br />$0.00 <br /> <br />12429 <br /> 0 <br /> <br /> THE <br />i'0 A~RE THAT <br /> <br />PLAN REVIEW; BY ' <br /> ........ DATE, <br />RE~ARKS: ~S <br /> <br />DATE <br /> <br />OFFICE COPY <br /> <br /> <br />