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MARION COUNTY BUILDING INSPECTION <br />COMMUNITY DEVELOPMENT CENTER <br /> <br /> 285 Church Street NE · Room 132 · Salem, Oregon 97301-3670 <br />Office Hours: 8:00-4:30 · Phone: (503) 588-5147 * 24-HR Inspection Line: (503) 373-4427 <br /> <br /> HECHAHIC~L PER,HIT <br />~ATE/TIHE = B7/~1/96 15-'B~ PERMIT NO <br />TYPE : Resident. addition/alteration STATUS <br />OCCUPAHCY : R-3 ISSUED <br />PAgE ; I TO EXPIRE <br /> <br />96-~4857 <br />ISSUED <br />67/61/1996 <br />12/28/1996 <br /> <br />WORK ~BC ...... ?I=~B-COR?~=gTR-RTR ......................................... <br /> <br />SITE ADDRESS : <br /> 12712 ARNDT RD NE AR <br /> <br />CROSS STREET : ROONES FERRY RD <br />PARCEL NIJMBER : 40215-000 <br /> <br />CITY: MARION COUNTY <br /> <br />LCCATOR: 041W03 009~ <br /> ZONE: EFU <br /> <br />OWNER NAME <br /> <br />APPLICANT <br /> NAME <br /> ADDRESS <br /> <br />PHONE <br /> <br />: CAMPBELL,TIMOTHY J & SHELLY L <br /> <br /> : ROTH ZACHERY HEATING INC <br /> : PO BOX 1265 <br /> <br /> CANBY, OR 97013 <br /> : 000-8688 <br /> <br />CONTRACTOR : ROTH ZACHERY HEATING INC OCCB: 8814888 <br /> PHONE : 800-0888 <br /> <br /> Units Description Fee <br /> ....... -I ..... Base fe~ 10.00 <br /> 2 Additional appliances 15.08 <br /> 1 Gas outlets 2.88 <br /> 1 State surcharge 1.~5 <br /> I Refund .00 <br /> <br /> Assessed fees 28.35 <br /> Adjustments .80 <br /> Total fees 28.35 <br />PAYEE: ROIH 7ACHERY HEATING INC Total payments: 28.35 <br /> Balance due : .00 <br /> <br />THIS PERHIT IS NON-TRANSFERABLE AND EXPIRES 18~ ~AYS FROff ISSUE DATE IF WORK HAS <br />HOT COMHENCED~ OR IF CONSTRUCTION CEASES FOR A PERIOD DF 186 DAYS~ OR IF WORK <br />~A}~E~OR~s~Lo~O~}F~T~o~HS~.H~M ~ ~R~N~TY ORDINANCES. UPON <br /> <br />SIGNATURE OF APPLICANT: <br /> <br />~)t]NAL,~) E WOO])LEY, MARION COONTY BUILDINC; OFFICIAL / BY <br /> <br /> <br />