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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 H~GH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />of ~ r6~gistered buil¢er, <br />The work wHI be 12edormed by a registered builder, <br />Other ,, <br /> <br />SIGNATURE OF APPI_JCANT: <br /> <br /> DATE: <br /> <br /> RANDY FUL'I'Z CONSI'RUCI'iON <br />SI]'U5 ADDRESS: <br /> <br />CATEGORY: <br /> <br />OCCUPANCY: <br /> <br />RESiDEN'IIAL. <br /> <br /> 5983 NALtNA COLJR'f <br /> AU~4SVi LLE <br /> <br />USE OF BUIL01NG; <br /> <br />OR 9'/3~5 <br /> <br />~E <br /> <br />CONTRACT CIT~ UGB: <br />F4AR I g~4 CDgUNf'Y NO <br /> <br />ROLLING GREEN ES'fATES <br /> <br />PHONE: 769~5386 <br /> <br /> 'IN 1 22 <br /> 155 412 <br /> <br /> 51TE NUDGER: <br /> VALUAT ! UN: <br /> <br />8S 2~ <br />SF YES <br /> <br /> '.'0585 <br /> <br /> AR 49 <br />NO <br /> <br />TYPE: PLUIV~ING PERMIT OR APPLICATION <br /> <br />CONTRACTOR, NO. <br />RANDY P~J L'FZ <br /> <br />27822 <br /> <br />PHONE: ?69-5886 <br /> <br /> ITEM <br />RE,SiO¢~'r~AL F~x'ruRE, NEN <br />PLUIV~NG BASE FEE <br />F'LEE'f' ~URCHARGE -ZONE <br />PLUmiNG STATE 5LJRCHARGE <br /> <br />PAYEE: RANDY P'UL'f'Z CONSTRUO;TION <br />RECEiVEO BY: PR <br /> <br />0UANTiTY A~OUNI <br /> 9 <br /> $20.00 <br /> $~.84 <br /> $5.05 <br /> <br />TO'FAL AE~ESSEO FE6,~ <br />PRE¥iOUSRECEiPTS <br />THISRECEIP'¥ <br /> <br /> BALANCE OUE <br /> <br /> RECEIPT NO~ <br /> TYPE= CK CHECK <br /> <br />$109.89 <br /> $0.00 <br />$109.89 <br /> <br />29412 <br /> %/33 <br /> <br />* THIS iS A VALID P~r.~iT~< THIS PERI~IT EXPIRP~ 180 OAY~ FRO~ iTS i,?~E OAI'E. [F <br />CONSTRUCTION CEA,~.~ EOR A PERIOD OF 180 DAYS, OR IF C~NSTRDCTiON FAiL~ TO MEET ALL <br />REQU[RF.~IENTS OF STATE LAWS AND t, IARiON C~JNTY 8UZLOING AND Z~NIN~ OROiNANCE~, THIS PERI~['I' <br />SHALL BECOME NULL AND VOID. <br /> <br />REMARKS; 9- FIX R~3331 <br /> ¢-~-'-....,--:, <br />[X)NALD E. WOGDLEY, f4ARiON COUNf'Y BUiLOiNG OFPiCiAL / BY ...................... ~.~ .......................... <br /> <br />OFFICE COPY <br /> <br /> <br />