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MARION COUNTY BUILDING INSPECTION <br />,,~ENATOR BLDG NO. 225 <br />220 HiGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-514'/ 8:00- <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> SIGNATURE OF <br /> <br />0AIE; 0S/01/gl TINE." <br /> <br />RF.~I DEN t t.~ <br /> <br /> 10846 STE,[NK.NtlP RD <br />ALINSV! LLE OR 97325 <br /> <br />PHONE.: 749-1935 <br /> <br /> 28 29 <br /> <br />TYPE: ON-~SITE ~ <br /> <br />PER~IT OR APPLICATIC~I NO.. <br /> <br />CONTRACTOR, NO. <br />8ERNT, <br /> <br />R",CN E: 749=1g$5 <br /> <br />~E <br /> <br />r~/ COUNTY ; NO ~ <br /> <br />~LL[A HE:.}L~TS ~3 <br /> <br />SITE NUP~EJ~: 0994 <br />VALUAT IGH .* <br /> <br /> RA <br /> <br /> ;[TEN <br />AUTHORIZAI-tON NOT[CE - FLD. VIfS[T <br /> <br />PAYEE; LIN[~N~N <br /> <br />TOTAL ~ FEE~ <br />lr'H 1~ R~C~I PT <br />8ALANC~ O, JE <br /> <br />f~CE/PT NO= <br /> <br /> $105.00 <br /> $1~5.oo <br /> $0.00 <br /> $105.00 <br /> <br /> $o.oo <br /> <br />33585 <br />1~6 <br /> <br />REiMARKS= .a~J1H FIELD C~IEC~ I~t7535 <br /> <br />CITY JURISDICTION= 8Y ......... <br /> <br />DATE ............. <br /> <br />OFFICE COPY <br /> <br /> <br />