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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 />~ORK ~ ..... ~-~XRT-F~R~-~-F~RR-SD~TR-F~TFRR~R-~-~=TTg~ ................ <br /> <br />S~TF AD~RF'~ = <br /> <br />CITY: MARION COUNTY <br /> <br />CR(1SR RTRFI:'T : <br />PARCFI. NIIMRFR : <br /> <br />FHIFN RD <br /> <br />.JOHHSflN, RflBFRT I. & KATHY I. <br /> <br />I.OCATOR: 041W~4D 014~0 <br /> <br />70NE: EFU <br /> <br />APPLTCANT <br />HAME : SCH[IMIJS THOMAS ~YRTI. <br />ADDRFSS : ?lR~ ROflHFS FFRRY R~ NF <br /> <br /> AIJROR~, OR <br /> <br />Cf}NTRACTflR = SCHOMIJS THOMAS ~YRTI. OCCB: 00~2965 <br /> <br /> ~e~ fee ~0.00 <br /> I Onm~tic f~n~/v~nts 3.00 <br /> ~ F~rn~r~ d~lCtS 7.50 <br /> I S~ surcharge 1.03 <br /> ~ R~ftmd <br /> <br /> Assessed fees 21.53 <br /> Adju~tn~ots .00 <br /> To~I f~es 21.53 <br />PAYFF~ fiCHOMHfi THOMAS CYRil Tnt~] p~yMe~ts: 21.5~ <br /> B~l~nq~ due : .00 <br /> <br />TH[S PEK'HIT TS NOH-TRAHSFERflBLg N4D EXPIRES 18~ I)~YS FROM ISSUE D~TE IF I~RK I~IS <br />MOT C~MFHCF~ ~ IF ~NST~TTOH ~ARFfl FOR A ~IOD OF 188 DAYS. OR IF WORK <br />F~I.~ T~ ~FT fill. R;GIJ;RFHFHTS ~ ~T~TF I.~BS ~0 H~R[~ C~HTY ORDZ~HCES. UPOH <br />~TTTFH RF~IFRT~ ~ ~X (~) H~H~ FXTFHST~H H~Y BE gRANTED. <br /> <br />SIiiNATURE OF APPI.~CANI*: <br /> <br />Of)NAI.O E WOOOI,~Y~ MARION F;OIJNTY BIJII.~TNfi FIFFIC~AL / BY CLYNCH <br /> <br /> <br />