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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 />I am performing work on 8 property I own or Occupy. <br />I am a registered builder OR ) the authorized representative <br />of 8 registered builder. <br />The work win be performed by a registered builder. <br />Other_ <br /> <br />I have read and agree to the terms stated on the reverse side of <br />this document. <br /> <br />OWNER; <br /> <br /> P,¢Q'E :; <br /> <br /> )AI...K~:./, DE;LBERI' <br /> <br />'~ LOT <br />CONSTRUCTION TYPE. <br />CONTRACT CITY'. <br /> <br />~O~E'~'F"WO E&-'¢~,~'~ 4- M~E_-~.:+:REEE--R'B .................... SE- ................................................ <br /> ~ ~1 OTiS V '[ I.,/',,,t: OR MARION COUNTY <br /> <br />CATEGORY: <br /> <br />OCCUPANCY[ <br />RESiDEN'I'~AL <br /> <br />OCCUPANT ~OAO <br /> <br /> ;NO OF B~DROOM8 <br /> <br />LOT : - ' ~t':'~SL~qF,'--201~ SECTION <br /> <br /> SiTE NU~]~ER: 9~'~25~ <br />...... f(~WNSHIP; VC~AUEr¢ I OI,I: ZONS MAP; <br /> <br />~'J 0 N O <br /> <br />TYPE: MECHANICAL <br /> <br />COt,I'fRC/C1T~I% I,IO., [41090 <br /> J)ay Hea'~:ing Co <br />225 Dlvi~io~ NE <br /> <br /> I1EH <br />FORC AIR FURNACE UNDER ¢.eeeee ~TU <br />OTHER (AS PER HECHANH:;AL 6OPE) <br />MKCI4AI,IICAL BASE FEE <br />MECHANICAL STATE SUR[iHAR~iE <br /> <br />PERNIT OR APPLICATION <br /> <br />QUANTITY AMOUN i' <br /> $2,, <br /> $¢%9(!} <br /> <br /> TOTAL,'A,S. SESSED FEES ~ 1 ~,,, .. 0 <br /> PREV,IOUS RECEIPTS, <br /> THIS RECEIPT SiS. <br /> <br /> BALANCE DUE SO,, <br /> <br /> PAX~E: ~ay He.~-I;ing Co RE(]EIPT qO: <br /> RhCF'IVED BY: JS,... ................................................... TYPE: CK CF~iECK ~:::'; <br />* THIS :S A VAL~ PERMIT * TH~S PERMIT EXPIRES 1Se DAYS FROM ITS ISSUE DATE. <br />CONSTRUCTION CEASES FS~ A PERIO~ OF 180 DAYS~ OR ,IF CONSTRUCTION FAILS TO MEET ALL <br /> EGUtREMEHTS OF STATE LAWS AND. M~RION CO~NTY BOILDING AND ZONING ORDINANCES, THIS <br /> ALL BECOME NULL AND VOIB. <br /> <br /> i'G.HAF~KS;, FA, (;AS CONNECIlON <br /> <br /> Df'~lrfY..D ':::. O00I)LI:Y,¢ MA~'!:OI'~ COUNTY BUILBING OFFICIAL BY <br /> <br />FORM # bio 16.56 R~V. 4/90 O F FICE COPY <br /> <br /> <br />