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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 <br />CODE-A-PHONE 4::30 PM - 8 00 A M <br /> <br />DATE: 07/27/89 TIME: 11:14~08a <br /> <br /> OL$ON, ROOERIC <br /> <br />RESI DENT <br /> <br /> 660 MICHAEL NAY <br />AUNS¥ILLE OR 9?325 <br /> <br />AUiVLSV I LLE NO <br /> <br />4933 JUNIPER CT N <br />KEIZER OR 9?303 <br />~qONE; 393-0769 <br /> <br />LOT B~.OCK SECTION <br /> 75 190 <br /> <br /> 25 8S <br />14250.0 SF <br /> <br />PARCEL <br /> <br />SITE NUMBER: ?930 <br />YALUAT I ON: <br /> <br /> 2W RS <br /> NO NO <br /> <br />TYPE: MECHANICAL <br /> <br />C~NTRAC'TOR. NO. <br />CLEON, RODERIC <br />4833 JUNIPER CT N <br />KEIZER OR 9?303 <br />PHONE¢ 392-0?69 <br /> <br />PERMIT OR APPLICATION NO: 9017712 <br /> <br /> ITEM <br />GAS CONNECTION <br />FLOOR MOUNTED UNIT HEATER <br />MALL HEATER <br />DOMESTIC RANGE HOOD <br />DOM BXHST FANS & DRYER VENTS <br />OTHER (AS PER MECHANICAL CODE) <br />MECHANICAL BA~E FEE <br />FLEET SURCHARGE ~ZONE ~ <br />MECHANICAL STATE SURCHARGE <br /> <br />TOTAL ASSESSED FEES <br />:PREVIOUS RECEIPTS <br />:THIS RECEIPT <br /> <br />0UANTITY AMOUNT <br />1 $2.00 <br />1 $6,00 <br />2 $12,00 <br />1 $4.50 <br />2 $6.00 <br /> $0.50 <br /> $10.00 <br /> $3.84 <br /> $2.05 <br /> <br />$46.89 <br /> $0,00 <br />$46.89 <br /> <br /> BALANCE DUE , $0+00 <br /> <br /> P~YEEt EMERY & SONS CONST. !:? ;~NVOICE NO: 18810 <br /> RECEIVED BY~. ~ ~ ~ ~~:'~,, , :TYPE: IN CHECK ~; 0 <br />......................... ==== .... =__~=~=~=~ ...... .-- ........................ <br /> * ~IS I8 NOT A PE~IT. ~IS::APPL[0ATI~---- ~ST ~ ~ A R~I~ P~ ~ERE ~E <br /> FOLL~ING ~ST BE ~PL~. IT IS ~E R~SISILI~ OF ~E APPLIC~T TO ~RE ~AT <br /> ALL NEC~ INFO~TI~ H~ 88~" P~DED. <br /> <br />PLAN REVIEN: 8Y ........... DATE ....... <br />REMARKS: GAS HTR HO FN <br /> <br />CITY JURISDICTION: 8Y ......... DATE ........... <br /> <br />;o~M¢~c,~.~e ~EV,~,ae OFFICE COPY <br /> <br /> <br />