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MARION COUNTY BUILDING INSPECTION <br />SENATOR ~LDG, NO, 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-514'7 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I 8m performing work on a property I own or occupy. <br />l am a registered builder OR ( )theauthorlzedrepresentative <br />of a (eBistered builder. <br />The work will be performed by a registered builder. <br />Other_ <br /> <br />I hsve read af~d agree to the terms stated on the reverse side of <br />this document. <br /> <br />SIGNATURE OF APPLICANT: <br /> DATE: <br /> <br />owi, E~A:f'E: 0'?/0~/91 'TIME: <br /> <br /> MCZNT'YRE, HAROLD <br />SITUS ADDRESS: <br /> <br />16:18:04 <br /> <br />RES l .)~N I A,.. <br /> <br />5510 WiNE7~OR ISLAND N- <br /> OR 97303 <br /> <br />i'~(~N~AC~ ~IT~: i UON: iOO~UI~XNT LOAD: <br /> <br /> PHONE; 2¢93-8929 <br />LO'f: BLOCK: : SECTION: <br /> <br /> SI f'E NUMI~ER: ,9'121 <br />TOWNSHIP: ~AN~/~.LUA:f ION: :: ZONE: <br /> <br />: MAP: <br /> <br />!UNITS: ; IRREO, LOT: <br />N0 ~ N~ <br /> <br />IYP~ MECHANICAL <br /> <br />CONTRACFOR, NO. 499 <br />C,J+ HANSEN CO. <br />PC) BOX ?39? <br />SALEM, OREGON 9?303 <br />PHONE: 352~,3543 <br /> <br />PERMIf OR APPLICATION NO: <br /> <br /> iTEM <br />HEAT PUMP <br />~ECHANICAL BASE FEE <br />MECHANICAL S'fA'f'E SURCHARGE <br /> <br />PAYEE: C.J. HANSEN CO. <br /> <br />33403 <br /> <br />I'OTALASS~ED FEES <br />PRE¥iOUSRECE[P'I'S <br />TH~S RECEIPT <br /> <br />QUANY'IY'Y A~OUNI <br /> <br /> $0,00 <br />$'~ 5_ so <br /> <br />BALANCE DUE SU-UU <br /> <br />RECEIP'f' NO: 35222 <br /> <br /> RECEIVED BY: Dr42 TYPE: CK QWECK ~: 15~88 <br />~ THiS IS A VALID PER~iT ~ THiS PE~tT EXPIRES 180 [:;)AY~ FROM iTS iSSUE DATE. IF <br />CONSTRUCTION CEASES FOR A PERIOD OF 180 DAY~, OR IPCt~I~TRUCTION FAILS TO MEET ALL <br />REQUiREmENTS OF STATE L.a~S AND MARION COUNTYBU[LOINB,N~IB ZONING ORDINANCE,,~, THiS PEF~I'I' <br />SHALL BECOME NULL ANO VOID. <br /> <br />REMARKS: HEAr ~IMP R~'7861 ~ <br />L×,)NALO E, WOODLEY, MARION COUNTY BUiLDiNG OFP'iCIAL / BY ................................. ....~ ~ ................ <br /> <br />eDItH # MO 15-56 Rb~*/. 4/~O OFFICE COPY <br /> <br /> <br />