Laserfiche WebLink
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 8m performing work on a property IOwA or occupy, <br />lamaregistered builder OR( ) the authorize'4 representative <br />of a registered builder, <br />The work will be performed by a registered bug:der. <br />Other. <br /> <br />I have read and agree to the terms stated on the reverse side of <br />this document, <br /> <br />~ CONTRACT CITY; ; UGh; OCCUPANT LOAD: <br /> <br /> ................................. ,.,..____.,_.,..~_,~ . <br /> , NO. 0F 8EOROOMS: <br /> <br />.... . SITE NUHDER: <br />FHON ,, VALUATSON: <br /> <br />TYPE.- MECHANICAL PER,lIT OR :APPLICATION NO: <br /> <br />COf,tTRACIOR~ NO. 0,~,.~0~ <br /> Salem l,.leaci¥~g & Sheet ~e't'al <br /> <br />Sale~% ?7389-ee~e <br />PFIONE: <br /> <br />ITEN QUAN'TiTY AMOUNT <br />GAS CONHEC'flON :: : <br />FORC AIR FUI~NACE UNDER leO~ ~'TU 1 <br />[4ECHANICAL BASE FEE 1 ~6., <br />MECHANICAL SI'ATE SURCHARGE <br /> $(4 ,, 99 <br /> <br /> i :', ~14,;rs: RESEZPT <br /> <br /> : BSL. ANCE DUE $,~. <br /> , , : · <br /> <br />PAYEE: ~,~,(~l,~ [.lea'~ing &:,S~ eot: He,at In:c' <br />~,~:r'-'ru,"n ~v INVOICE NO: <br /> <br />ALL BECOHE NULL AND VOID, ~ <br /> <br />DOt,!ALD E, WOODI../T.:Y, OFFZC~A'L /BY <br /> <br />FORM # MC 1 ~-58 ~EV, 4/90 OFFICE COPY <br /> <br /> <br />