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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 />lamaregisteredbutlderOR( )theauthorizedrepre~entative <br />of a registered builder, <br />Tne work will be performed by e registered builder, <br />Other <br /> <br />I)ATE: 12101194 TIME: 12:32:18 <br /> <br />SIGNATURE OF APPLICANT: <br /> <br />I ~OELLER, RUSSELL F)'~l~t~- :1, 00 ,~ef~'~ I A ,., <br /> <br /> lle 180 le'fH ST -- : <br /> AUHSVILLE OR 97325 ~'~[~fg',. [~: i'SddO~T LOAm <br /> <br /> ! SMITH'S ADI):[TION <br />5058 COMMERCIAL ST SE <br />SALEM,~ OR 77,~02 <br />PHONE: 370-7802 i VALUATION: <br /> <br />TYPE: PLUMBING PERNIT OR APPLICATION NO: <br /> <br />CONTRACTOR~ NO. 10122 <br />BO PLUMBIN~ <br />1615 PINE <br />~ILVER'fON. 97381 <br />FHONE: <br /> <br /> Il'EH <br />COMHEROIAL FIXI'URE~ NEW CONST. <br />WATER LINES~ 1ST ~00 FEET <br />SEWER LIHES. 1ST 100 FEEl' <br />ADBITIONAL PLUMBING FEES <br />PLUNBING BASE; FEE <br />PLUHBING STATE SURCHARCE <br /> <br />PAYE£: BO PLUMBI <br />R~CEIVEQ BY: <br /> <br />TOTAL ASSESSED FEES <br />PREVIOJS RECEIPTS <br />THIS 'RECEIPT <br /> <br />BALAPICE BUE <br /> <br />QUANTITY AMOUNT <br />32 $288.00 <br />1 $20.00 <br />1 $30.00 <br />1 $4.50 <br /> $20.00 <br /> $18.1~ <br /> <br />$683.03 <br />.... $302,40 <br /> <br /> $0.00 <br /> <br />INVOICE NO: ~2580 <br />TYPE: CE 6HECK ~: 0 <br /> <br /> ~ THIS IS A VALII) PERHIT t THIS PERNIT EXPIRES 188 ])AYS FROH ITS ISSUE ])ATE. IF <br />COI,ISTRUCTT:ON CEASES FOR A PERIOD OF 18~ DAYS~, OR' IF CONSTRUCTION FALLS TO HEET ALL <br /> ALL BECDHE HULL AN~ VO)~. , ', <br /> <br /> SPR K ' <br /> R~.MARKS. ~2 FIX ~ LAWN IN LER~ WL~ SL <br /> 90NALD E. WOODLEY~ MARION COUNTY BuILB~NG OFFICIAL / BY <br /> <br />OFF)CE COPY <br /> <br /> <br />