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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-PHONE 4:30 P,M. - 8:00 A,M.
<br />
<br /> DATE: 09/11/89 TIME: 9:57;38~
<br />OWNER:
<br /> ?,ORAN, TOM
<br />
<br />SITUS ADDRESS:
<br />
<br />TAX LOT: CATEGORY:
<br /> 900S1
<br />
<br />CONSTRUCTION TYPE: OCCUPANCY;
<br />
<br />R ES ! 3 EN T iii A[
<br />
<br /> 9'!0 10TH PL
<br />AI,.~fv!SV [ !.t_.E OB 9?325
<br />
<br /> CONTRACT CITY; UGB;
<br />AUMSVILLE NO
<br />
<br />MAILING ADDRESS.
<br />
<br /> BOX ~ S5
<br />StJBt. ZM[TY OR 97385
<br />~,~"i(,)N E; 789--736~
<br />
<br />~ 1 95
<br /> 70 ! 09
<br />
<br />Gl L00U ~2
<br />
<br /> SITE NUMBER: 8338
<br /> VALUATION:
<br />
<br />8S 2~ RS
<br />SP YES NO
<br />
<br />MAP:
<br />
<br /> 5'i
<br />
<br />TYPE: MECHANICAL PERMIT OR APPLICATION NO:
<br />
<br />CONTRACTOR, NO. 55493
<br />-["Or~ DC)RAN
<br />OD ;_.-JOX ! 85
<br />SUBLIMITY 9?385
<br />::>HONE: 759-7364
<br />
<br /> ITEM
<br />OOMEST ZC F<ANGE HOOD
<br />DOM EXHST FANS & DRYER /~'4TS
<br />M,F. CHANICAL 8ABE FEE
<br />~¢I._EET SLIRCHARGE -'ZONE 4
<br />MECHANIC;At, STATE SURCHARGE"
<br />
<br />9018776
<br />
<br />TOTAL ASSESSED FEES
<br />PREV~gUS RECEIPTS
<br />THIS RECE] PT
<br />
<br />DUANT ! TY AMCUN T
<br />~ $4.50
<br />3 $9-09
<br /> $ 'i 0,93
<br /> $5. ~2
<br />
<br />$99.80
<br /> $0. C 0
<br />$29.38
<br />
<br />BALANCE DUE $0.00
<br />
<br /> PAYEE: ~"C)m DORAN CE~ST ,~ : "~' ' ":~',A , , ,,I,,NVOiCE NO: 19905
<br /> RECEIVED BY: P9 ~ "', ,~ "¢ ~1. '] , , TY~,,'11~ ,CHECK ~.
<br />.................................................... ~._~, _~%~~7~~ .... ~ ................................
<br /> * THIS IS NOT A PE~IT. ~IS :A~,[~ATI~ ~ST' GO 'TH~ '~A ,R~l~ P~E~ ~ERE ~E
<br /> FOLL~ING ~ST BE ~PLETBB.',Y'~'~;',,,t,S'%H~' ,, RES~SZBIUZ~' OF ~E 'APPLICANT TO ~RE THAT
<br /> ALL NEC~RY INFO~TI~ ,'H~i~BE~,' P~MZBED.' , : ' ' ," ,,' , ,
<br />
<br /> PLA%~ RY,/IE?4. 8Y .......... D/~TE ..... ~ ' ' ' CitY' JLJRISDI,CTZON: [4Y
<br /> ~E~4ARKS: ?49 FN
<br />
<br />FORM ~' MC 15-56 R~V II/f~. OFFICE COPY
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