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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 5,88-5147 <br />CODE-A-PHONE 4::30 P.M. - 8 O0 AM <br /> <br />I am performing work on a property I own or occupy <br />lam are?steredbuilderOR{ / the authorized representative <br /> <br />this document <br /> <br />SIGNATURE OF APPUCANT <br /> OATE <br /> <br /> 12/04/89 TIME: <br />S,IUSADD~, TOM <br /> <br />TAX LOT <br /> <br />CONSTRUCTION <br /> <br />CATEGORY <br /> <br />OCCUPANCY RESIBENTIAL <br /> <br />855 8TH <br />AUI'4SVI LLE OR 9'/:325 <br />U~E OF BUILDING AU~VILLE NO Nfl OF BEOR00M5 <br /> <br /> OELJ'4AR III <br /> PO BOX 188 <br /> SUBLIMITY OR 97385 <br /> PHCNB: ?69-?384 SITE NUMBER: 8926 <br />lOT BLOCK :SECTION TOWNSHIP ~]~L,JAT ~ ON ~ ZONE MAP <br /> <br />WIDTH19 D~PTH 5 iAREA 25 UNITS 8S IRREG LOT~N CORNER~ <br /> 7.5. 100 7500.. SF NO NO <br /> <br />51 <br /> <br />TYPE: PLUMBING <br /> <br />PER~V~IT OR APPLICATION NO; 20463 <br /> <br />CONTRACTOR, NO. 28638 <br />T_G_NICHOL PLUMBING, INC <br />P.O.BOX 166 <br />AU~3V~LLE, OR 9?:325 <br />c'HONE: 749-2071 <br /> <br /> ITEM <br />RESIDENTIAL FIXTURE, NEW CONST_ <br />PLUN~ING BASE FEE <br />FLEET SURCHARGE -ZONE :3 <br />PLUffBING STATE SURCHARGE <br /> <br />PAYEE: <br />RECEIVED BY: PB <br /> <br />QUANTITY AN1OUNT <br /> 8 $54.00 <br /> $28.00 <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />~81.54 <br /> 81.54 <br /> $0.00 <br /> <br />BALANCE DUE $0_00 <br /> <br /> INVOICE NO: <br />TYPE: CHECK ~: 0 <br /> <br />$ THIS IS A VALID PEI~IT m THIS PERMIT EXRIRF~ 180 DAYS FROM ITS ISBUE DATE. IF <br />CONSTRUCTION CEASES FOR A PERIOD OF 180 DAYS, OR IF CONSTRUCTION FAILS TO MEET ALL <br />REQUIREmENTS OF STATE LANS AND f4ARION COUNTY BUILDING/~4D ZONING ORDINANCES, THIS PERMIT <br />SHALL 8EOO~4E NULL AND VOID. <br /> <br />REMARKS: 8 FIX <br /> <br /> NOODLEY, MARION COUNTY BUILDING OFFICIAL / BY ......... _¢'¢/~_ ........... <br />DONALD <br /> E. <br /> <br />~=O~M ,, M~ I: h,: ~=~F~ 6,e~ OFFICE COPY <br /> <br /> <br />