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MARION COUNTY BUILDING INSPECTION <br /> SENATOR BLDG NO 225 <br /> 220 HIGH STREET NE <br /> SALEM, OREGgN 97~0~1 <br /> <br /> PHONE $88-$147 <br /> CODE-A-PHONE 4::30 PM - 8::00 AM <br /> <br /> I am performing work on a property I o',~n or occupy <br /> <br /> I have read an~ agree to the teFm~ stai~d ~n th~ F~;~rse ~ide of DATE <br /> <br />DATE: 09/26/89 TINE: 3:08=28p <br /> FULTZ, RANDY <br /> <br />R~IDENTIAL <br /> <br /> 10047 STAYI'ON RD SE CONTRACT C~TY UGB <br />AUMSVI LLE OR 97325 <br /> ~RION COUNTY NO <br /> <br />U~S OF SUILDING <br /> <br />OCCUPANT LOAD <br /> <br /> NO OF BEDROOMS <br /> <br /> PHONE: 769-5386 <br /> <br />LOT BLOCK SECTION TOWNSHIP <br /> <br /> 18 <br /> <br /> 20. 0000 <br /> <br /> SITE NUNBER = 1445 <br /> VAL.UATt(~N: <br />~AN~ ZONE <br /> 1W ER) <br />IRREG LOT CORNE~ <br /> NO NO <br /> <br />MAP <br /> <br />TYPE: PLUMBING <br /> <br />PERN[T OR APPLICATION NO.* <br /> <br />C~NTRACTOR, NO. 47677 <br />DAVE FARRELL PLUF~IN~I <br />2030 COMNERCIAL 8T NE <br />SALEN, OREGON 9?303 <br />PHONE.- !581-5957 <br /> <br />ITE~4 <br />RESIDENTIAL FIXTURE, NEW CONST. <br />WATER LINES, 1ST 100 FEET <br />SEWER LINES, 1ST 100 FEET <br />PLUNBING BASE FEE <br />FLEET S~URCHARGE -ZONE 3 <br />PLUIv~ING ,STATE SURCHARGE <br /> <br />PAYEE: RM,~DY FULTZ <br />RECEIVED BY: ~ <br /> <br />19182 <br /> <br /> OUANTITY AMC~JNT <br /> 12 $108.00 <br /> 1 $20.00 <br /> 1 ~30.00 <br /> $20.00 <br /> ~3.84 <br /> 8.90 <br /> <br />TOTA~AE~ES~EDcFEES $190.74 <br />PRE~IOUS.RECE'IPTS $0.00 <br />THIS;/RECEIPT $1g0.74 <br /> <br />.BALANCE DUE $0.00 <br /> <br />RECEIPT NO: 20349 <br />~ ~ _ TYPiE~! ~ CHECK ~: 4E52 <br /> <br />* THIS ~$ A VALID PERt4IT ~, mis P~I,T ,ID{P3~RES 190' ~ ~ ~ I~E ~. IF <br />R~I~ E STATE ~ ~D '~[~:.=~=~i~]~.~D,,~I~ O~]~, ~[S ~IT <br /> <br />R~RKS: 12 FI~SL ~71~1 <br /> <br />~ALD E. ~DL~, ~RI~ ~N~ BUILDING OFFICIAL / <br /> <br />I~O~ ~ ~C 1~,~6 .Er I,~ OFFICE COPY <br /> <br /> <br />