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MARION COUNTY BUILDING INSPECTION <br /> SENATOR BLDG, NO. 225 <br /> 220 HIGH STREET NE <br /> SALEM, OR;CON 97301 <br /> <br /> '" PHONE:588-5147 8;00- 4:30 <br /> 24 HOUR CODE-A-PHONE: 588-7904 / / ¢' i f <br />I~"~ I em a registered builder OR ) the authorized representative SIGNATUR~ OF APPEl <br />~ ~ T~.~ork will be performed by a reglstere~ builder. <br />( } I have reed ~nd agree to the terms stated on the reverse side of CATE: <br /> this document, <br /> OATE~ 05/28/92 TIME: 11:43~23 <br />;OWNE~: H~KiNS , ~ERI' J JR+ TAX LOT 71050072 :CATEGORY. RESiD~I'I~ <br /> <br /> ~ITU$ ADDRESS: ~ CONSTRUCTION TYPE'. <br /> <br />J ~ViLLE OR 97225 [ ~RI~ ~NI'Y <br />,U~ b~ ~ulLDIN~; NO <br /> <br />~ 600 ~ V~E~T <br />~RT~O, OR 9?225 <br />; ~E. 271-0482 SITE NU~ER: 92-02014 <br /> VALUA T <br /> <br /> ;WOTH ~EPTH AREA: I 74 {UNITS; AC ~ IRREG. LOT: y~CORNER:No <br /> ' i i ' , <br /> <br />TYPE.+ PLUMBING <br /> <br />PERMit OR APPLICATION NO: 9040250 <br /> <br />CONTRAC'rOR. NO. <br />HAWKINS , ROBERT J JR. <br />600 ,~NVIE'1HMONF OR <br />PORTLAND, OR 97225 <br />PHONE~ 371-0483 <br /> <br /> iTEM <br />WATER LiNE~, 1s'r lOO FEET <br />PLUFI~ING STATE E~JRCHARGE <br /> <br />PAYEE= HAWKINS , RQ~ER3 J J'R. <br /> <br />TOTAL A,,~.~ED FEB <br />PREVIOUS RECEi PT$ <br />THIS RECEIPT <br /> <br />QUANTITY AMOUNT <br /> 1 $20.00 ,~ <br /> $1.oo :: <br /> <br />$21.00 <br /> $0.00 <br />$21.00 <br /> <br />BALANCE 0UE $0.00 <br /> <br />RECEIP'r NO: 42289 <br /> <br /> RECEIVED BY: CL .......................................................... tYPE: CK CHECK ~.* 1007 <br /> <br />· THiS US NOT A PER,lIT. THIS~:,APPLICATION IMU~T ,,~. ~ A R~I~ P~ ~ ~E <br />~IN6 ~T BE ~.~.'~,' ,i~'. IS ~,'. ~IBiLI~ ~ ~E APPLi~T TO ~RE THAT <br />~ N~ IN~Ti~ ~ B~, P~ID~.' <br /> <br />PLAN REVIEW; BY <br /> <br />REMARKS-* 100 F'F WL <br /> <br />DATE <br /> <br />CITY JURISDICTION: BY .......................... DATE ..................... ,;~ <br /> <br />OFFICE COPY <br /> <br /> <br />