Laserfiche WebLink
MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO, 225 <br />';'20 HIGH STREET NE <br /> SALEM, OREGON 9'[301 <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 /> <br /> DATE:: 05/27/~ TIME: <br />OWNER: TAX LOT: <br /> NO~)DERN BOIl_DING SYS'~'ENS~ <br /> <br />SITUS ADDY~ESS: CONSTRUCTION <br /> <br />SIGNATURE OF APPLICANT: //~,"ww~'~''~ ~ ~ <br /> <br />EOHNERCIAL <br /> <br /> 949S F'ORTFR F¢O SE <br />AU~SVILLE,, OR 97325 <br /> <br />KENNETH. A RASHUSSEN.~ P.E, ~ <br />PO BOX 258 TUALATZN~ OR ~7862 S~TE HUHBE~: ~-88828 <br />Pl"lOb~g: 749-4949, VALUA'flON: <br /> <br />TYPE: HECHANICAL PERHIT OR APPLICATION ~0: ~47~7~ <br /> <br />[.OItTRA(.TOR. NO,. <br />MOQQERll BUILDING SYoTE~S~ <br />KENNETH ~ <br />PO BOX 25~ TUALATIN,~ OR ~7~2 <br />PHONE: 749-"494~? <br /> <br /> ITEM QUANTITY <br />FORD AIR FURNACE UNDER 1D888~ BTU 1 <br />MECHANICAL BASE FEE <br />HECHANICAt. PLANS REVIEW <br />MEBHANICAL STATE SURCHARGE <br /> <br />AMOUNT <br /> $5,00 ~ <br /> $10.00 ' <br /> $4,00 <br /> <br /> TOTAl_ ASSESSED FEES $20,.~0 <br /> PRE¥IOUS RECEIPTS $0.00 <br /> THIS RECEIPT $20.80 <br /> <br /> BALANCE BUE $0.00 <br /> <br /> PAYEE: ~ODDERN BUILDING SYSTEMS~ IHC ~IE£~I~T HO: 4~544 <br /> RECEIVED BY: Ct__ ............................................ 'TYPE: CK CHECK :~: 5479~ <br /> <br />~ THIS IS HOT ~ PERHIT. THIS APPLICATION NUST ~ TH~OUCH A REVIEW PROCESS WHERE THE <br />FOLLOW~N~ HUST BE COHPLETE~. IT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT <br /> LL NECESSARY INFORHATION HAS BEEN PROViDEB. <br /> <br />PLAN REVIEW: BY QATE <br /> <br />REMARKS: HAVA6 SYSI'EN-~O~-O~'ICE <br /> <br />OFFICE COPY <br /> <br /> <br />