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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 />DAT£/*rIH~ PERHIT NO <br />TYPE STATUS <br />OCCUPt~C¥ ISSUED <br />PAGE TO EX'P IRE <br /> <br />WORK 1)~.BC ..... ,;-~F.T~_R?-I:~3:T-~CT-[ :FORR- .................................. <br />SITE ADDRFSS : CITY: STAYTON <br /> <br />CROSS STRFFT : <br /> <br />PARCEl, NUMBER <br /> <br />OWNER NAME : <br /> <br /> HECHANICAL PEP, HIT <br /> <br />Resident. addition/eIteration <br />R-3 <br /> 1 <br /> <br /> 1385 HIGHLANB OR ST <br />PINE <br /> <br />LOCATOR: 891W11BD83888 <br /> ZONE: RS <br /> <br />SHITH, LARRY A & BARBARA <br /> <br />APPLICANT <br />NAME : LORENS HEATING & SHEET METAL THC <br />ADDRESS ~ 2355 HYACINTH ST HE <br /> <br /> SALEM, OR 97383 <br /> PHONE : 378-7&48 <br /> <br />CONTRACTOR : I.ORENS HEATING & SHEET METAL INC OCCB: 8887594 <br /> PHONF : 37B-7648 <br /> <br /> IJnit~ DescriptionBase fee Fee <br /> I Forced air~ over 188.888 BTU <br /> 1 A~r conditioners, 3 tons & up <br /> 1 State surcharge <br /> 1 Refund <br /> <br />96-~6486 <br />ISSUED <br />~B/21/1996 <br />~2/17/1997 <br /> <br />10.08 <br /> 7.88 <br />11.88 <br /> 1.48 <br /> <br />Assessed fees : 29.48 <br />Adjustments : <br />Total fees : 29.48 <br />PAYEF: LORFNS HEATING & SHEET METAL INC Total payments: 29.48 <br />Balance due : <br /> <br />THIS PERNIT IS NON-TRANSFERABLE AND EXPIRES 1~ DAYS FR(]H ISSUE DATE IF k~RK HAS <br />NOT C(!NI~NCED, OR XF CONSTRUCTXOR CEASES FOR A PERXOD OFIUS ~AYS. OR XF ~ <br />FALLS TO HEET ALL REgUIRERE#TS DF STATE LANS AND HARXON COUNTY ORDXNANCEt~. UPOR <br />iJRITTEN RE, lEST, ONE SIX (6) I~I'ITH EXTENSION HAY BE GRANTE~. <br /> <br />SIGNATURE OF APPLICANT: <br />******************************************************************************** <br />DONALD E WOOBLEY, MARION COUNTY BUILDING OFFICIAL / BY DSTONE~ <br /> <br /> <br />