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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 />lamaregisteredbullderOR( )the~ut~orlzedrepresentative <br />of a registered builder. <br /> <br />Other <br />~ have read end agree to the terms stated on the reverse side of <br /> <br /> OWNER; TAX LOT'. CATEGORY; <br /> I~A[;S]DAI,,E,~ MICHAEL 9~040-,,~;80 RESIDENTIAL <br /> <br /> AUMSVILL. E OR 97~25 ~UMSVZLLE ~ NO <br /> <br /> . ~ DELMA~ III : <br /> PO ~OX 384 ' F ........................................................................... <br /> AUHSVI[.LE OR ~7~25 J ~[TE HU~BER: ~4-~2252 <br /> PHONE: 749-~9~2 ~ j VALUATION: <br /> <br />.....~,,?,~ ~- ~ ;~A~ ~: ~L ........~.~.~_~ ~ ............. ~,. -8~' ' L,¢~" <br /> <br /> TYPE: PLUNBING PERHIT ORiAPPLICATION <br /> <br /> CONTRAC?R~ NO. 34604 <br /> Judsons <br /> PO Box 12669 <br /> Sai, em~ 97309-0000 <br /> PHONE: 36g-4141 <br /> <br /> ITEM <br /> RESIdENTIAL.FIXTURE, <br /> PLUHBING BgSE FEE <br /> PI,JJMBING STATE SURCHARGE ,:i~ <br /> <br /> FAYEL. Judisons I¥~c <br /> RECEIVED BY: J$ ........... <br /> <br /> * THiS IS g VALID <br />CONSTRUCTION CEASES FOR <br /> EOUIRENENTS OF STATE <br /> ALL BECONE NULL AND <br /> <br />REMARKS: 4 ALT FIX <br />DONALD E,, WOODL,,EY, <br /> <br />57171 <br /> <br /> QUANI'I'FY AMOUNT <br /> 4 ' $~]6.90 <br /> <br />.... :~ $2,, 80 <br /> <br /> $58,, 80 <br /> '"::"' :;: $8. e8 <br /> <br /> INVOICE NO: 59683 <br /> ~ TYPE: CK CHECK ~: 6528 <br />::~'~ ~OH ITS ISSUE QATE. IF <br /> F~Z~S TQ ~EET ALL <br /> ZBHIH6 O~D~HA~CES~ THIS PE~H~'T <br /> <br />OFFICE COPY <br /> <br /> <br />