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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />22~ HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:80 <br /> 24 HOUR CODE~A-PHONE: 588-7904 <br /> <br />~ ~m per ormln9 work on a property I own or occupy, <br />I am a registered builder OR ( ) the authorized representative SIGNATURE OF APPLICANT: <br />of a registered builder, <br /> <br />Other <br /> <br />OWNER; DATE-; 1t/~1/94 r, fflE:t.Z:.~,~; ~5 ........... i yXS< ro~; : GATEGORY: <br /> VOE[ LER,~ RtJSSEL 9~i~e-l~ ~ <br /> <br /> AUMSVILLE OR 97~25 ~ ~UMS~ILLE NO <br /> ~'~'~,~15~: <br /> <br /> 5¢~8 COMMERCIAL ~T SE <br /> SALEM~ OR 97~82 ~ SITE NUMBER: ~4-83881 <br /> PHONE: ~7~-7882 ~ VALUATION: <br /> <br />TYPE: <br /> <br />PERHIT OR APPLICATION NO=.. 5975E <br /> <br />CONTRACTOR~ MOo 10122 <br />BC PLUMBING <br />1615 PINE ST <br />SILYERTON~ 77~81 <br />PHONE; <br /> <br /> ITEM <br />COMMERCIAL FIXTURE~ FlEW CONSl'. <br />WATER LINES, tSl' 188 FEEl <br />SEWER LINES, 1ST 188 FEET <br />ADDITIONAL PLUMBING FEES <br />PLUMBING BASE FEE <br />PLUMBING STATE SURCHARGE <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />BALANDE:DUE <br /> <br />FAYEE. BETHEl. OONSTRUCTION <br />RECEIVED BY: jm ...................................... <br /> <br />ASOUNT <br /> 4576.88 <br /> 420.0~ <br /> <br /> $4.58 <br /> 42~.80 <br /> $~2.~ <br /> <br />$68~.03 <br /> $0.00 <br /> <br />40.00 <br /> <br /> ~NVOICE NO: 62336 <br />TYPE: CK CHECK ~: 2708 <br /> <br /> · THIS IS A VALID PER~I~ * THIS PER~IT EXPIRES 184~ 9AYS..FROfl iTS ISSUE DATE. IF <br />COHSTRUCTIOH CEASES FOR A PERIOD 0F ~8~DAYS~ OR, IF CONSTRUCTION FAILS TO NEET ALL <br /> EQUIRENENT~ UF STATE LAMS ,AN~ HARIOH,COUHTY.BU~EBIHG AND ZONlN6 ORDIHANCES~ THIS PERHIT <br /> ALL BECOME NULL AHD VOID. <br /> <br /> REMAREo. APARTMEIITS 110-180 101H, 115-185 ,gTH <br /> <br />DONALD E. WOODLEY~ MARI:ON COUNTY BUILDING OFFICIAL / BY <br /> <br /> OFFICE COPY <br />FORM # MC 15,56 R~v'. 4/90 <br /> <br /> <br />