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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 /> of a re¢istered builder. / <br /> OtherThe work will be performed by a registered builder, <br /> this document. <br /> <br /> HAYN~, MiKE RE~DEN]'.tA <br /> ~ViLLE O~ 97325 : <br /> <br /> ~E: 3?3-8438 · / SiT/ NU~ER~ 92~02001 <br /> ; /. VALUAT i~, <br /> <br />WIDTH: ,DEPTH; : AREA: UNWS:~ , IRREG. LOT; NO ~ OORNER~o <br /> <br />TYPE: MECH,/~ICAL PE~,~[T OR APPLi( NO-' <br /> <br />CON'I'RACI'OR, NO. 00499 /' <br />C J h~anS~ Co Znc <br />PO Bo× 7397 /, <br />~alecn, 97909-0000 <br />PHONEt 362-3543 //' <br /> <br /> zrB~ / qUANi T¥ A~OUN~ .... <br /> <br /> MECH~i~L B~E FEE / ~-~ $10_00 <br /> MEtriCAL STATE ~A~ -~ $0.80. <br /> <br /> / PRell8 RECEIPT~ SO.e0 <br /> ~' THIS RECEIPT $16,80 <br /> <br /> _ . DANCE ~E $0. O0 ',' <br /> PAYEE~ C .... J Han~ ~ [nc' ~ [N~1CE' NOz ~264 <br /> <br />~T~CTI~ ~ ~R A PERIOD OF 180 ~, OR IF ~T~CTI~ FAI~ TO ~EET A~ <br />~IR~T~/OF STATE ~ ~O ~I~ ~NTY ~iLO[N~ ~D Z~ING ORDINal. THIS <br />~LL B~ ~LL ~O ~ID. <br />~ ~. ~, ~ ~-,.~ ~, o~-~ ~ ~ ..................... ~ ............................................... <br />/ <br /> <br />FORM # MO 15-56 REV. 4lQ0 <br /> <br />OFFiCECOPY <br /> <br /> <br />