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MARION COUNTY BUILDING INSPECTION <br />SENATORBLDG 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 />I am performing work on a property I own O¢ OCCUpy <br />I ~marop~storodbuddorOR( ~ the authorized representativo <br />of a registered builder, <br />The work wifi be per'fOrl¥~Od Dy a registered builder <br />Other <br /> <br />SIGNATURE OF APPLIC&NT <br /> DATE <br /> <br />~¢¢,~: 11/28/89 <br /> BORAN. TON <br />SITUS AOORESS <br /> <br />TIMEr 11:13:26 <br /> <br /> TAX LOT <br /> <br /> 90040-260 <br /> CONSTRUCTION TYPE <br /> <br /> CONTRACT CI"Y UGS <br /> <br />AUMSVILLE NO <br /> <br /> 895 8TH <br />AUt,~VILLE <br />USE OF RUItDING <br /> <br />OR 9?325 <br /> <br />MAILING ADDRESS <br /> <br />PO SOX 185 <br />SUBLIMITY OR 97385 <br />PHONE: 769-?364 <br /> <br />I CT BLOCK SECTION TOWNSHIP <br /> <br /> DELMAR III <br />SITE NUMBER: <br /> <br />W~DTH23 DEPTH 5 AREA 25 UNITE 8S I~REG LOT2w <br /> 74 100 7400, SF NO <br /> <br />CATEGOEY <br /> <br /> RE~I DENT IAL <br />OCCUPANCY <br /> <br />ooog PANT LOAD <br /> NO Ok <br /> <br /> 892? <br /> <br /> ZONE MAP <br /> <br />CONNER R~ 51 <br /> NO <br /> <br />TYPE: MECHANICAL PERMIT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. 55493 <br />TOl'4 DOPC¢I <br />PO BOX 185 <br />SUBLIMITY 97385 <br />PHONE: 789-7384 <br /> <br /> ITEN <br />DOf~ESTIC RANGE HOOD <br />DON EXHST FANS & DRYER VENTS <br />MECHANICAL BASE FEE <br />FLEET SURCHARGE -ZONE 3 <br />MECHANICAL STATE SUROHAR6E <br /> <br />PAYEE; TON DORAN <br />RECEIVED BY: F~8 <br /> <br />90204?0 <br /> <br />QUANTITY ~UNT <br />1 $4.50 <br />3 $9,00 <br /> $10.00 <br /> $8.84 <br /> $1.18 <br /> <br />TOTAL ASSE,%SED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />$28.52 <br /> $0.00 <br />$28.52 <br /> <br />BALANCE DUE $0+00 <br /> <br />INVOICE NO: 21723 <br />TYPE: IN CHECK ~: 0 <br /> <br />* THIS IS NOT A PE~IT. THIS APPLICATION ~UST GO THROUEH A REVIEN PROCB WHERE THE <br />FOLLONIN8 ~JST BE COMPLETED. IT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT <br />ALL NECEE~ARY INFO~4ATION H~ BEEN PROVIDED. <br /> <br />PLAN REVIB4: BY DATE <br />REfCCNRKS: HD FN <br /> <br />cITY JURISDICTION: BY <br /> <br />DATE <br /> <br />OFFICE COPY <br /> <br /> <br />