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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 588-5147
<br /> CODE-A-PHONF 4:80 P.M, - 8:00 A.M.
<br />
<br />DATa! 89/11,/S9 TIME: 9:58:29a
<br /> DC)RAN, TOM
<br />
<br /> 910 !O'!'H PL
<br />.,.~o/ILLE OR 97825
<br />
<br />AUMSV,~ LLE
<br />
<br />UGB:
<br />
<br />NO
<br />
<br />PO BOX 185
<br />!%rSLIM!TY OR 9?38.5
<br />F>HONE: 789-,,.7364
<br />
<br />'~ ! 25 SS
<br /> ?0 "08 SF
<br />
<br />GI LDON ~2
<br />
<br />SITE NUMBER: 8338
<br />VALUATION:
<br />
<br /> YES NO
<br />
<br />TYPE: Pl,,Uf¢,~31NG
<br />
<br />CONTRACTOR. NO.
<br />~!ERY & SONS CONST,
<br />, O BOX 398
<br />ST'AYTON,~ ORE 9738:3
<br />~!'ION E: ~' 69,-,'7 75 '!
<br />
<br /> ITEM
<br />
<br />~ENEh; L~N¢o, ,~. !80 FEE?
<br />P!_LI~3ING SA.SE FEE
<br />FLEET SURCHARGE -'-ZONE 4
<br />P[_UNtBING STATE SURCHARGE
<br />
<br />PERMZT OR APPLICATION NO: 9018780
<br />
<br />TOTAL ASSESSED F~ES
<br />~HIS RECEI P~'
<br />
<br />MAP:
<br />
<br /> 5!
<br />
<br />QuANTI~Y AHOUNT
<br />
<br /> $30..00
<br />
<br /> $2. S0
<br />
<br />$78_62
<br /> $0,
<br />
<br /> ,, 8ALANC,,. JU~ $0.
<br />
<br />~AYF. E. ,Oq l/Or~Ak ,..ONe> ,,~ ~4' ,,,, ,, ~ ~'NVOiCE NO
<br />
<br />THIS Is NOT A PE~ZT. THI~,~{~PL,ICATI~.~ST ~,TH~GN A:,R~I~ P~E~ ~ERE THE
<br />FOLL~ING ~UST BE ~PLETBO. ,{,,},q'[~,~',[S 'THE,~ 'AES~S,IBILIT~', ~ ~E'APPLIC~T TO ~RE THAT
<br />ALb NECE~ARY INFO~TI~ ~(SE~,:' P~V,IDED. , ' , ',"' ~'
<br />
<br />::~LAN REVISU: 8v ........... DATE__~ ......... CITY UR.SDI~, ION. _ ...................
<br />qE,v'gRKS: ~4. T~R/SEWE~ L!~ ES ,
<br />
<br />¢o¢u ,~ Mc ~.~ ~E'~ .Ca. OFFICE COPY
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