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MARION COUNTY BUILDING INSPECTION <br />SENATOR SLDG, 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 />I am performing work on a property I own or occupy. <br />I am a reDiStered builder OR ) the authorized representative <br />of a registered builder. <br />The work will be performed by a registered builder. <br />Other <br /> <br />J have read 8nd agree to the terms stated on the reverse side <br />this document. <br /> <br />i J.~7~ [..¢i,I{il~,t[~Jt']J~ ~)P~, hie CONTRACT CITY; i gGB; {OCCUPANT LOAD: <br />~ AURORA <br /> <br /> MAI~ING ADDRESS; ~ SUBDIVISION: <br /> <br /> ~ ~ SITE NUMBER: 94-818~8 <br />~ .%ION.;.: 678-1458 ~ALUAT]]ON: <br /> <br />TYPE: HECHAMICAL <br /> <br />(.0111F(A ,, fOR. NO. <br />SH;~Tt't,~ JAMES ALLEN <br /> <br />PERMIT OR APPLICATION NO: 54958 <br /> <br />PHONE: 678.-1450 <br /> <br /> I'l EH <br />FORE AIR FURNACE t. JHI)ER I00000,B'FU <br />DOH EXHST FANS & DRYER VENTS <br />~'IEEHAN:I;CAL BASE FEE <br />MEC. HANICAL Sl'A'~E SURCHARGE <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />QUANTITY AMOUNT <br />1 <br />1 $3.00 <br /> $10.00 <br /> <br />$19.75 <br /> <br /> $0.80 <br /> <br />BALANCE DUE $8,,00 <br /> <br /> RECEIPT NO: <br />TYPE: CHECK ~: 0 <br /> <br />PAYEE: <br />RE, CE,, VFD <br /> <br /> $ THIS IS A VALID PERMI~ * THIS PERHZT EXPIRES 18~ DAYS FROM ITS ISSUE DATE. IF <br />COMSTRUCTIOH CEASES FOR A. PERIOD OF ,188 DAYS~ OR IF CONSTRUCTION FAILS TO MEET ALL <br />EOUIREMENTS OF STATE LAWS AMD MARION COUNTY BUILDtH~ AMD ZONINg ORDINANCES, THIS PERHIT <br />ALL BECOME MULL AND'VOID. <br /> <br />I,~EM(/RkS,, REI.OCA'i'E FURN,~ BATH FAN <br />DONALO I"_'. WOO1)LE.Y~ HA~ION COUNTY BI.I',[I:.DZN6 OFFICIAL / BY . ...........................~ ................................. <br /> <br />FORM # MO 15-56 R~. 4190 OFFICE COPY <br /> <br /> <br />