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MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> <br /> ~ Chu~ Stm~t NE · Room 132 · ~lll~, Ort~on 97301-3670 <br />Office Houm: 8:00,4:~0 · Pholm: (503) ~8-5147 · 24-HR In~l~k~n LIr~: (503) 373-4427 <br /> <br />DATF/TTRF <br />TYPE <br />OCCUPN~.Y <br /> <br />WORK DF~C <br /> <br /> PI.IB4~TI4G PFRt4TT <br /> <br />t <br /> <br />: 1OR' WATFR IH/I~F~FR /~N~.KFt OW <br /> <br />CROSS ~;TREET t <br /> <br />PARCFI NIIM~FR t <br /> <br />DWNFR NAMF ~ <br /> <br />APPI.ICANT <br /> NAMF : <br /> <br /> PHONE <br /> <br />CDNTRACTOR <br />PHr~E <br /> <br />PtlIHRFR <br /> PHflN~ <br /> <br /> 562 ))TH ;T ~ <br />FROM CITY WATER I.THE 'F' TO HOII~E <br />5776~-~4~ <br /> <br />Ft~RHIT ~ = 96-~9304 <br /> <br />,, I <br /> <br /> TO EXPIRE ~ 65/28/1997 <br /> <br /> CITY: MA~TY <br /> <br />PRflPFRTY [[1CATOR: OB2W25A 00?99 <br /> 70NE-- UTF <br /> <br />FTHF~IT,RORFRT <br /> <br />DK )NVFSTMFNT C~ [1~ <br />P49~ I.ATOHA CT HE <br /> <br />KF~7FR, PR <br />~9~-7R39 <br /> <br />DK SNVFSTMFNT CO [lC <br />~gR-7R~9 <br /> <br />OCCBr B100841 <br /> <br /> LICENSE: <br />Hn~t~ Pe~cr~pf~on Fee <br />1 PllJMhin~ ba~e fee 2~.0~ <br /> <br /> Other backf)ow dPvJce~ <br /> <br /> As,~es~ed fees : 84.06 <br /> <br /> Total fees : 84.00 <br />PAYFF,. DK TNVFSTHFNT CO tIC Tokai paymentsg 84.8~ <br /> 8alanc~ due : <br /> <br />FTiF~'[g_P_[R~J]T T~ __I~N,I=TI~FER~M..E ~N9 F. XPIRE.6 18~ ~Y9 FI;fl IgSUE D~TE IF ~ HA6 <br /> Il com~l~Fjm, ~R IF C014STRUf~TION (~M~'S F'~...A PFRIOD~I~ DAYG, OR IF ~ <br /> ~=.~Q_NIEF. T ~.m. R~.GUERFJ~ENT~ rlF ~T~T£ I~ ~ HARI~N..C~UNTY (~DIN~CCEO. UPON <br /> <br />~TGNATIJRE OF APPI.TCANT: ................................ ~ ............. <br /> <br />00HALO E WOOOI.EY~ MARTOH C01JNTY 8IJTI_D[NG 0FFTC[AL. / BY TTOHEY <br /> <br /> <br />