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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: 588-8147 8:00 - 4:30 <br /> 24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am performing work on 8 property I own or OCCUpy, <br />I am a registered builder OR the authorized representative SIGNATURE OF APPLICANT <br />of a registered buitder, <br />The work will be perlormed by a registered builder, <br />Other <br /> <br />this document, <br /> <br />SAME <br /> <br />FMOIqE. <br /> <br /> SITE NUMBER-- 93-82652 <br /> VALUATIOIq: <br />T~ANGE;i I ZONE; ~ MAP: <br /> <br />TYPE: HECHANICAL PERMIT OR APPLICATIOH NO-' <br /> <br />CON'rRACTOR. NO. <br />HAWORTH~ DON <br />SAME <br /> <br />PMONE: 678-..501~ <br /> <br /> ITEM <br />DOM EXHST FANS & DRYER VENT8 <br />APPLIANCE OR ACCESSORY (NOT COVERED <br />MECHANICAL BASE FEE <br />HECHANICAL STATE SURCHARGE <br /> <br />PAYEE: HAWOR'rH~ DON <br />RECEIVED BY: CL <br /> <br />.TOTAL ASSESSEB FEES <br />PREVIOUS RECEIPTS <br /> [HI~..RECEIPT <br /> DUE' <br /> <br />QUANTITY AMOUNT <br />4 $12.00 <br />1 $4.58 <br /> $10.00 <br /> $1.~ <br /> <br />$27.83 <br /> $0.00 <br />$27.83 <br /> <br />RECEIPT NO: 53:l,~5 <br /> <br /> _ _ - ......................................... TYPE: CK CMECK ,~: 14392 <br /> * THIS IS A VALID PERMIT *:"'THIS",PERNITEXPIRES 180DAYS FROM ITS ISSUE DATE, IF <br />CONSTRUCTION CEASES FOR A,PERiODOF '188 DAYS~ OR IF CGNSTRUCTIOH FAILS TO MEET ALL <br /> EOUIREMENTS OF STATE LAWS AND MARION COUN~Y'BUILD~NG'ANDZONING ORDINAHCES, THIS PERMIT <br /> ALL BECOME HULL AHD VOID. <br /> <br />REMARKS: DRYER/BATH VENTS &'DUCTS <br /> <br />DONALD E. WOODLEY,~ MARtOM COUNTY BUILDING OFFICIAL / BY .................................................. <br /> <br />FORM # MG 15.5~ R~, 4/~0 OFFICE COPY <br /> <br /> <br />