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MARION COUN~;Y 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: 04/12/89 TIME: 12:43;04p <br /> SMITH, FRED <br /> <br /> 310 LAKECREST DR <br />DETROIT OR 97342 <br /> <br />USE OF BUILDING: <br /> <br /> SIGNATURE OF APPLICANT: ........ <br /> <br /> DATE: <br /> <br /> TAX LOT: <br /> <br />' co~'r~C'cciYY:' ' UGB'. <br />DETROIT NO <br /> <br />CATEGORY: <br /> <br />OCCUPANCY: <br /> <br />RES I DENT I AL <br /> <br />OCCUPANT <br /> <br /> NO, O¢ BEDROOMS: <br /> <br />MAILING ADD'ESS: <br /> <br />13367 PORTLAND RD NE <br />GERVAIS, OR 9?026 <br />PHONE: 634-220? <br /> <br />LOT: BLOCK; SECTION: TOWNSHIP: <br /> <br /> 1 10 <br />WIDTH; DEPTHI AREA; UNITS: <br /> 108 161 17388.0 SF <br /> <br />SITE NUM~ER: 6889 <br />VALUATION: <br /> <br /> 5E M/F <br /> NO NO <br /> <br />MAP: <br /> <br /> 105 <br /> <br />TYPE: MECHANICAL 2EP34IT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. <br />SfVlITH, FRED <br />t3367 PORTLAND RD NE <br />GERVAIS, OR 9?026 <br />PHONE: 634-220? <br /> <br /> ITEM <br />DOM EXHST FANS & DRYER VENTS <br />MECHANICAL BASE FEE <br />FLEET SURCHARGE -ZONE ? <br />MECHANICAL STATE SURCHARGE <br /> <br />9015151 <br /> <br />PAYEE: <br />RECEIVED BY; CL <br /> <br />QUANTITY .AMOUNT <br /> ~ $3.00 <br /> $10.00 <br /> <br /> $0.65 <br /> <br />~ THIS IS NOT A PEE~IIT. <br />FOLLOWING f~UST BE COI~IPLETED.,, <br />ALL NECESSARY INFOB4&TION <br /> <br />PLAN REVIEW: 8Y <br /> <br />REMARKS: BATHRM EXHT FAN <br /> <br />$22_81 <br /> $o.oo <br /> $0,00 <br /> <br />$22.61 <br /> <br />IElal PROCESx.$ ~IERE THE <br /> TO ~RE THAT <br /> <br />BY DATE <br /> <br />OFFICE COPY <br /> <br /> <br />