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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO, 22§ <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 />o a cegistered builder. <br /> <br />Other <br /> <br />this document, <br /> <br />MAILING ADDRE~L,. ~;UI3OlVl~lO N; <br /> <br /> .t <br />Gl,/.~; CONNECTION <br />FO~C AIR FI,IRNAf,~E UNl~ER i~tOOeO BTU <br /> <br />OTHER (AS PER ~ECHAN].CAL CO~E) <br />~ECI4ANI6AL. BA~)E FEF~ <br />HECHAN:f. CAL STATE SURCHARBE <br /> <br />TOTAL ASSESSE~ FEES <br />PRE¥IOUS RECEZPTS <br />THIS RECEIPT <br /> <br />BAL. ANCE DUE <br /> <br />FmAYF:Eu Hart HerhanicaJ inc RECEIPT NO: 62'J. 84 <br />RE:CE'IVE:P BY~ HB ...................................................................... TYPE: <br /> <br />ALL BECOME NULL AH~ VO[~. , <br /> <br />¢o~u # MC t5.5~ R~V, 4~ OF FICE COPY <br /> <br /> <br />