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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: 888-7904 <br /> <br /> of a resistered builder, <br /> %he work wIH be pedorme¢ by a registered builder, <br /> Other. <br /> I have read and asree to t~e terms stated on the reverse side of DAT~: <br /> <br /> CATE: 09/08/92 TZHE: 8:14:55 <br />OWNER; T~X' [O~'. : CAT~GORYL <br /> ROSE, FRANKLIN ~ RESIDENTIAL <br /> <br />SiTbS ~bDh~SS: [ CONSTRUCTION TYPE'. OCCUPANCY: <br /> <br /> i1544 JAMES ~AY SE ~ OCCUPANT LOA0 <br /> RUHSVZLLE OR '7525 ,[~UNTY ~' .(. ' <br /> <br /> 5210 RIVER ROAD N ~iO00 ~ ........ <br /> KEIZER 97503 OFFICE 395-3624 X-550 I SITE NUMBER: 92=05i99 <br /> PHONE: 390~9553 ~ V~LU~TION: <br /> <br /> as ' nR 48 <br /> <br />TYPE: PLUNBING <br /> <br />PERHIT OR APPLICATION NO: 9042405 <br /> <br />CONTRACTOR, NO. <br />ROSE, FRANKLIN <br />5210 RIVER ROAD N ~1000 <br />KEIZER 97505 OFFICE 395-3624 <br />PHONE: 390-9~53 <br /> <br /> ITEM <br />WATER LINES, iST lO0 FEET <br />WATER LINES, EA. ADDL. 100 FEET <br />SEWER LINES, iST 100 FEET <br />PLUMBING BASE FEE <br />PLUMBING STATE SURCHARGE <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />QUANTITY AHOUNT <br />i $20.00 <br />2 $30.00 <br />l $S0.00 <br /> $20.00 <br /> $5.00 <br /> <br />$105,00 <br /> $0.00 <br />$105.00 <br /> <br />  BALANCE DUE $0.00 <br /> <br />PAYEE: ROSE, FRANKLIN ~ RECEIPT NO: 44467 <br />RECEIVED BY: OM2 ..... .... ~__ TYPE: CK CHECK ~: 1006 <br /> <br />THIS I$ NOT ~ PERHIT. THIS APPLICATION:HUST GO THROUGH A REVIE# PROCESS #HERE THE <br />FOLLO#iNG ~UST BE CONPLETEO.: IT IS,THE RESPONS[B~LZTY OF THE APPLICANT TO ASSURE THAT <br /> LL NECESSARY INFORNAT[ON H~S::SEEN PROVIDED. <br /> <br />PLAN REVIEW: BY .......... O~TE <br />REMARKS: WL/SL <br /> <br />CITY JURISOICTION: BY ........ CATE ......... <br /> <br />OFFICE COPY <br /> <br /> <br />