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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 8:00 - 4::30 <br />24 HOUR CODE-A-PHONE:: 588-7904 <br /> <br />10/25/90 1 .[ME: 14;23:22 <br />f.,)UNN, TIM <br /> <br />SIGNATURE OF APPLICANT <br /> DATE <br /> <br /> TAX LOT <br /> 57816-909 <br /> <br /> 745 MICHAEL NAY <br />AUt4SVILLE <br /> <br />USb OP BUILDING <br /> <br />OR 97325 <br /> <br /> CONTRACT CITY UOB <br />AUMGViLLE NO <br /> <br />SUBDIVISION <br /> <br /> BOX 290 <br />AJUM~iViLLE, OR <br />PHC~IE: ?49-2576 <br /> <br />LOT BLOCK <br /> <br />97325 <br /> <br />t00 315 <br /> <br />SECTION ¥OWNSHIP <br /> 25 <br />AREA UNITS <br /> O. <br /> <br />SITE NUIVE~ER: <br /> VALUAT ION t <br />RANGE' <br /> <br /> 2W <br />IAREG LOT <br /> YP~ <br /> <br />QATEGORY <br /> RESi O~J~ r ~ Al. <br />OCCUPANCY <br /> <br />OCCUPANT LOAD <br /> <br /> 11453 <br /> <br />NO <br /> <br />TYPE: MECHANICAL PERMIT OR APPLiCA1J. ON NO: <br /> <br />~"fRACTOR, NO+ 234? <br />8'I'AY'ION REPRiGERAIlON <br />207 N 3RD <br />51'AYTON, ORE~ 9'1383 <br />PHONE; ?69-3495 <br /> <br /> ITE~ <br />HEAT PUMP <br />DOfVlESI'iC RANGE HOOD <br />E~)M E"~Hs'r FAN~ & O~ER V~TS <br />~E~i~L B~E FEE <br />FLEET ~A~E ~Z~E 3 <br />~EC~ANI~L STATE ~A~E <br /> <br />PAYEE: <br /> <br />280?8 <br /> <br />TOTAL ~E~ED FEES <br />PREVi~LI5 RECEIPTS <br />f'HI5 RECEIP[ <br /> <br />qu~rlrY ~OUNi <br /> <br /> 1 $4.50 <br /> 4 $12.00 <br /> $10.OD <br /> ~3.84 <br /> 1.83 <br /> <br />$ ,3 't. 9 ? <br />$3'1.97 <br /> $o.0o <br /> <br />BALANCE DUE $0 i 00 <br /> <br />INVOICE NO: <br /> <br /> RECEIVED BY: PR rYPE: CHECK ~: 0 <br /> <br />~ TH15 I~A VALID PE~IT * TH15 PEI~IIT [~;PIRES 180 DAYS PROM IT5 I.%.,~UE OATE. iF <br />~T~CTI~ C~ ~R A PERIOD ~ 180 ~, OR IF ~8T~Ti~ FAI~ TO ~EET ALL <br /> <br />REMARKS: HP, F~, EXH,~F5 <br /> <br />LVJNALD E. ~¢.)ODLEY, MARION COUNTY BUILDING OFFICIAL / BY <br /> <br /> OFFICE COPY <br />FORM # MC 11~-t~6 REV 4/90 <br /> <br /> <br />