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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 />Iarn a registered builder OR( ) the authorized representative SIGNATURE OF APPLICANT: <br />of a registered builder, <br /> <br />Other_ <br /> <br />DWN~ATE: 04,/28/92 <br /> <br />SITUS ~ADDRESS~ <br /> <br /> T [ NE: 8 z 24 .+ 25 TAX LOT CATEGORY: <br />~ ........ CONSTRUCTION TYPE. 7~-¢~'BO~"[ OB OCCUPANCY <br /> <br />RESiDENI'iAL <br /> <br /> 20701 OLMSTEAD RD <br /> AU R'ORA <br />USE OF BUILDINC <br /> <br />OR 97002 <br /> <br />NE <br /> <br />CONTRACT CiTY UGB OCCUPANT LOAD <br />MARION C~N'IY NO No OF BEOROOM5 <br /> <br />LOT <br /> <br />WI4, ~t 538-,3141 <br />PHONE: 678-1082 <br /> <br /> BLOCK. <br /> <br /> SITE NUMBER: 92-01442 <br />SECTION TOWNSN IP RAN~2~.A[C~AT I 0~ ~. ZONE <br /> <br />lB JNITS: 4S IRREG. LOT 1N CORNER EFU 4 <br /> <br /> 5. AC NO NO <br /> <br />'TYPE: MECHANICAL PER~IlI' OR APPLICAl'lON NO: <br /> <br />OON'rRACTOR, NO. <br />BRANNON, RON <br />SANE <br />NK ~ 538-3141 <br />PHONE: 678-1082 <br /> <br />APPLIANCE OR ACCP.,~RY (NOT COVERED), <br />MECHANICAL BA~,E FEE <br />MECHANICAL S'rA'rEsuRQtAReE <br /> <br />9039633 <br /> <br />Q~J.~N 1' I I'Y AMOUNT <br /> $4.50 <br /> $10+00 <br /> <br />PAYEE:BRANNON, <br />RECEIVE0 BY: CL <br /> <br />TOTAL ASSESSEDFEES <br />PRE¥1OUS RE~EIPT~ <br />THiS RECEIPT <br /> <br />$15.23 <br /> $o.oo <br />$15.23 <br /> <br />BALANCE OUE $0.00 <br /> <br />RECEIPT NO: 41677 <br />TYPE: CK CHECK ~: 719 <br /> <br /> THIS IS NOT A ~IT. THt~ APPLICATION I~UST GO THi~Ui~I A REViEI~ PROCESS ~E THE <br />~L~[NG ~T BE ~T~ IT IS THE R~IBILITY OF THE ~PLi~T ~ ~RE THAT <br />A~ N~ IN~Ti~ ~E~ <br /> <br />PLAN REVIEW: BY DA'rE <br /> <br />REMARKS: F'URN DUCT EXTENSION/ P~39305 <br /> <br />CiTY JURI:SDIC'FION; BY DATE <br /> <br /> OFFICE COPY <br />FORM ~ MC 15-56 REV, ,~/~O <br /> <br /> <br />