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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO. 22,5 <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 />~ am perform{rig work on a property I own or occupy. <br />l am a registered builder OR ( ) the authorized representative <br />of a reeistered builder, <br />The work wUI be performed by 8 registered builder. <br />Other. <br /> <br /> DATE: 09/04/92 TIME: 16:36:14 <br /> <br />°WNEn;LIFFLANDER, JOHN & CAROL <br /> <br />SITUS ADDRESS: <br /> <br />SIGNATURE OF APPLICANT~ <br /> DATE; <br /> <br /> 8851 SMITH RD <br />AUMSVILLE <br /> <br /> SE <br />OR 97525 <br /> <br />MAILING ADDRESS: <br /> <br />5290 BALSAM OR S <br />SALEM OR 97302 <br />PHONE: 565-6418 <br /> <br />WK 378-5738 <br /> <br />SUBDIVISION: <br /> <br />SITE NUMBER: 92-01640 <br />VALUATION: <br /> <br />LOT: <br /> <br />WIDTH; <br /> <br />OCCUPANCY: <br />OCCUPANT LOADZ <br /> <br /> N0 0~ 8EOR00MS: <br /> <br />24 8S 2W SA 51 <br /> <br />TYPE: PLUMBING <br /> <br />PERMIT OR APPLICATION NO-' 42119 <br /> <br />CONTRACTOR, NO. <br />LIFFLANDER, JOHN & CAROL <br />3290 BALSAM DR S <br />SALEM OR 97502 WK ~78-~738 <br />PHONE: 363-6418 <br /> <br /> ITEM <br />~TER LINES, [BT [00 FEET <br />PLUMBING STATE 8URCHRRSE <br /> <br />TOTAL ASSESSEO FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />QUANTITY AMOUNT <br /> 1 $20.00 <br /> $1.00 <br /> <br />$21.00 <br />$21.00 <br /> $o~oo <br /> <br />BALANCE DUE $0.00 <br /> <br />PAYEE: RECEIPT NO: <br /> <br />RECEIVEO BY: DM2 ................... TYPE: CHECK <br /> <br />* THis IS A VALID PERHIT · THIS PERMIT EXPIRES 180 DRYS FROM ITS ISSUE DATE. IF <br />CONSTRUCTION CEASES FOR R PERIOD OF 180 DAYS, OR IF CONSTRUCTION FAILS TO NEET ALL <br />EQU[REHENTS OF STATE LAMS AND MARION COUNTY BUILDING AND ZONING ORDINANCES, THIS PERHIT <br />SALL BECOHE NULL AND VOID. <br /> <br />REMARKS: <100 FT WL ~ <br />DONALD E. WOOOLEY, MARION COUNTY BUILDING OFFICIAL / BY ................... .~__.~.,.____ <br /> <br /> OFFICE COPY <br />FORbl # MC 15-56 REV, 4190 <br /> <br /> <br />