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MARION COUNTY BUILDING INSPECTION <br />SENATOR 8LOG. NO, 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 588-5147 <br />¢CODE. cA-PHONE 4 30 PM - 800 A M <br /> <br />I am perferm~n§ ~vork on 8 property I own or occupy <br />I am a reg,stered builder OR ( / the authorized representahve <br />of a reglsterOd builder <br />The work will be performed by a registered builder <br />Other <br /> <br />SIGNATURE OF APPLICANT <br /> DATE <br /> <br />°w~CA'h-E; 05/10/89 <br />SITUS AODRES500~;~t~N , TOM <br /> <br />895 9TH ST <br /> <br />TIME: 9:49:55m <br />OR 97325 <br /> <br />TAX LOT <br />CONSTRUCTION TYPE 900~0~050 <br />0ONT~AOT CITY UGB <br />AUIvE~VI LLE NO <br /> <br />OCCUPANCr RESIDENTIAL <br /> <br /> P,O. 8OX 185 <br /> SUBLIMITY, OR 9?285 <br /> PHONE t 769-?364 <br />LOT BI,,OOK <br /> <br />TOWNSHIP <br /> <br />SITE NUMBER: 720? <br />RANG'CALUATION: ZONE <br /> <br />MAP <br /> <br />74. 105. <br /> <br /> 25 UNITS 85 IRRE~ LOT 2W COHNEH ~ 51 <br />7770.00 SF¢ NO NO <br /> <br />TYPE: PLUMBING <br /> <br />PERMIT OR APPLICATION NO.* <br /> <br />CCNTRACTOR, NO. 55493 <br />TOM DORAN <br />PO BOX 185 <br />SU8LIMITY 97385 <br />~ONE~ ?69-?384 <br /> <br />ITEM <br />RESIDENTIAl_ FIXTURE, NEW CONST. <br />WATER LINES, 1ST 100 FEET <br />SENER LINES, 1ST 100 FEET <br />PLUMING BASE FEE <br />FLEET SURCHARGE -ZONE 3 <br />PLUMBING STATE SURCHARGE <br /> <br />PAYEE: TOM DORAN <br />RECEIVED BY; cl <br /> <br />9015799 <br /> <br />OUANTITY AMOUNT <br />6 $54.00 <br />1 $20.00 <br />1 $30.00 <br /> $20-00 <br /> <br />TOTALASSESSED FEb <br />PREVIOUS REOEIPTS <br />:THIS RECEIPT <br /> <br />$134.04 <br />$134.04 <br /> <br />BALANCE DUE $0.00 <br /> <br />:INVOICE NO; 16790 <br />TYPE: IN CHECK ~: 0 <br /> <br />* THIS IS NOT A PE;~4IT. THIS:APPLICATION f~UST'~O ]]4ROUGH A RE~IEN PROCESS NHERE THE <br />FOLLOWING f4JST BE COMPLETED. IT IS THE RESPONSIBILITY OF 'FHE APPLICANT TO ASSURE THAT <br />ALL NECESSARY ZNFOI~TION H~NS ,BEEN PROVIDED. <br /> <br />PLAN REVIEW: BY .......... DATE <br />REMARKS: 6 FIX, WL ,SL <br /> <br />CITY JURISDICTION: BY <br /> <br />DATE .......... <br /> <br /> <br />