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MARION COUNTY BUILDING INSPECTION <br />SENATOR BI~DG NO 225 <br />220tHIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONE 4::30 P.M - 8 O0 A..M.. <br /> <br />Other_ <br /> <br /> i ha~e read and agree to the terms stated on the reverse side of <br /> <br />DATE; 05/29/8? TINE: 4:00:14p <br /> <br /> JEE, RONALD A. <br /> <br /> 12123 FRY ROAD NE <br />AURORA OR 97002 <br /> <br />UEE OF EUILDING <br />MAILING ADDRESS <br /> <br />RE~IDENTIAL ACC~$,C~DRY STRUCTURECS <br /> <br />SIGNATURE OF APPLICANT <br /> <br />DATE <br /> <br />TAX LOT <br /> 40864-000 <br /> <br />SUBDIVISION <br /> <br /> SAME <br /> <br /> PHONE*. 678-1544 SITE NUIVlBER: <br /> VALUATION: <br /> <br />LOT 8LOCK SECTION TOWNSHIP FRANCE ZONE <br /> 21 4S 1N <br />WIDTIt DEPTM AREA -------UNITS IRREG LOT CORNER <br /> 4 <br /> 50000 <br /> N <br /> <br />CATEGORY <br /> R <br /> <br />OCCUPANCY <br /> 1'41 <br /> <br />OCCUPANT LOAD <br /> <br />NO OF OEOROOM5 <br /> <br />1397 <br /> $4,608.00 <br /> <br /> MAP <br /> <br /> EFU 5 <br /> <br /> N <br /> <br />TYPE: BUILDING <br /> <br />CONTRACTOR, NO. <br />~¢~1~ RONALD A. <br /> <br />PHONE: 878-1544 <br /> <br />PERMIT OR APPLICATION NO: 2182 <br /> ARCHITECT/ENGINEER, NO. <br /> <br /> ITEN <br />BUILDING FEE <br />PLAN REVI E~ <br />FLEET SURCHARGE -ZONE 6 <br />STATE ~JRCHARGE <br />ZONING SURCHARGE <br /> <br />PAYEE: <br />RECEIVED BY: PB <br /> <br />QUANTITY ANOUNT <br /> $50.50 <br /> $32.83 <br /> ~?.68 <br /> 2.02 <br /> $2.53 <br /> <br />TOTAL A...%.~ED FEES <br />PREVICUS RECEIPTS <br />THIS RECEIPT <br /> <br />295.65 <br /> 95.56 <br /> $o.oo <br /> <br />BALANCE DUE $0.00 <br /> <br /> INVOICE NO= <br />TYPE: CHECK <br /> <br />~ THIS IS A VALID PER~IT ~ THIS.,i~IIT iEX~_[R~ 180 DAYS FRCN ITS ISSLJE DATE. IF <br />CON~¥~CTICN CEA~ FOR A PERIOD OF 180 DAYS¢ OR, IF CONSTRUCTION FALLS TO NEET ALL <br />REQUIREMENTS OF STATE i-N4S AND I~ION COUNTY BUILDING AND ZONING ORDINANCES, THIS PERI'lIT <br />SHALL 8ECONE NULL AND VOID. <br /> <br />sETBACKS: FR.-20 LB-lO RS-lO ;]:RR~30 "$p,%~ <br /> <br />HEIGHT: TOTAL ~ ~:I~ Iii : ~68 ST~ ~iI~ ~ ~ .~;'~i~~i~--~ ~ON *. <br />DONALD E. N~DL~, ~rI~ ~'8U~'ED~NG' O~P~'~ '/ 8Y ~ ....... <br /> <br />OFFICE COPY <br /> <br /> <br />