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MARION COUNTY BUILDING INSPECTION <br />SENATOt~ 13LDG, 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 AM <br /> <br />SIGNATURE OF APPLICANT <br /> DATE <br /> <br />~= 11/28/89 TINE: t1:12:65 <br /> TAX LOT <br /> BORAN , TOM 90040-360 <br /> <br />895 8TH CONTRACT CITY UGB <br />AUMSVI LLE OR 97325 <br />us~ o~ uu~U~N~ AU~VI~LE NO <br /> <br />CATEGORY <br /> <br /> RESI DENT IAL , <br />OCCUPANCY <br /> <br />OCCUPANT LOA0 <br /> <br /> DELMAR I I I <br /> FO BOX 185 <br /> SUBLIMITY OR 97385 <br /> PHONE: 769-?364 SITE NUMBER: 8927 <br /> VALUATION: <br />LOT $~ OCK SECTION TOWNSHIP RANGE ZONE MAP <br /> <br /> 23 5 25 8S <br /> 2W <br /> 51 <br />WIDTH DEPTH A, REA UNITS IRRE6 LO~--' ' CORNER <br /> 74 1 O0 7400. SF NO NO <br /> <br />TYPE: PLUMBING <br /> <br />PERMIT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. 28638 <br />T.G.NICHOL PLUMBING, INC <br />P.O.BOX 166 <br />AUMSVILLE, OR 97325 <br />PHONE: 749-2071 <br /> <br /> ITE~ <br />RESIDENTIAL FIXTURE, NE~ CONST. <br />PLUMBING BASE FEE <br />FLEET SURCHARGE -ZONE 3 <br />PLUMBING STATE SURCHARGE <br /> <br />PAYEE: TOM DORAN <br /> <br />9020468 <br /> <br />TOTAL ASSESSED FEES <br />PRECIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />(~JANTITY AMOUNT <br /> 6 <br /> $20.00 <br /> 33.84 <br /> <br />$81.54 <br /> $o.oo <br />$81.64 <br /> <br />8ALANCE DUE $0.00 <br /> <br />INVOICE NO= 21721 <br /> <br /> RECEIVED BY: PS TYPE: IN CHECK ~: 0 <br /> ............... ~--~.,..:: ~: ~-'"~£ ~_,._,., ~ <br /> ~ THIS IS NOT A PEI~IIT. THIS APPLICATION MUST 60 THR~tJ(~I A REVIEW PROCESS ~r{ERE THE <br />FOLLOWING MUST BE COMPLETED. IT iS THE RESPONSIBILITY OF THE APPLICANT TO A~SUEE THAT <br />ALL NECESSARY INFORNATION HAS BEEN PROVIDED. <br /> <br />PLAN REVIEN: BY ........ DATE <br />REMARFv~: 6 FIX <br /> <br />CITY JURISDICTION: BY ........ DATE <br /> <br /> <br />