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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGOM' 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br /> 24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am ~ registered builder OR I ) the authorized representative <br />of a registered builder, <br /> <br />DATE: 07/21/':)2 <br /> <br />BARRELL, RICHARD <br /> <br />TIME: <br /> ~ LOT'. ;i ~ATEG~R¥; <br /> · RESIDENTIAL <br /> <br /> 11675 LARK CT NE ~ ................. ~ ....... <br /> AURORA OR 97002 ~ ~c~"~ c~(~"UNTY i u~a: IOCOUPAN'r UOAD: <br /> <br />,U~E OF BUILDING: <br /> <br /> CENTURY HEADOWS <br /> <br /> ORE~ON C~TY OREGON ~7045 SITE HUHBE~: 92-02455 <br /> PHOHE: ~63'"'20~3 V~LUAT[ON: <br /> <br />: 28 ; 3~ 3~ 1W ~ AR : 1 <br /> ' AREA: ~ UNIT : , tR~G, LOT: ' CORNER; <br />WIDTH: ~5 ,DEPTH: ~5 ~ 5525. ; ~F ~ YE~ <br /> <br /> TYPE: ~ECH~N[C~L PEE~T <br /> <br />CONTRACTOR~ NO, <br />BARRELL~ RICHARD <br />16341 SO. STOLTZ <br />OREBON CITY OREGON <br />PHONE: ~63-2063 <br /> <br />97045 <br /> <br /> ITEM <br />HEAT PUMP <br />MECBANICAL BASE FEE <br />MECHANICAL STATE SURCHARGE <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br /> <br />QUANTITY AMOUNT <br /> 1 $6.00 <br /> <br /> $0.80 <br /> <br />$16.80 <br /> :OOoo <br /> <br /> PAYEE: RECEIPT NO: <br /> RECEiVEO BY: .: TYPE: CHECK ~: 0 <br /> <br />* THIS IS NOT A PERMIT. THi'S APp~T'cAT:IDN,:HO~T GO THROUGH n REVIEW P~OCESS WHERE THE <br />FOLLOWING MUST BE COMPLETED.~.:: IT ,J:S;THE: RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT <br />LL NECESSARY INFORMATION HA8 BEEN PROVIDED~ <br /> <br /> DgT~ <br /> o~'rY JURISOICTIU~Y~??--~ U~y~]]~]~~] <br /> REMARKS: MEAT PUMP <br /> <br /> OFFICE COPY <br />FORM # MC 15,56 R~. 4J90 <br /> <br /> <br />