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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONE 4:30 P.M, - 8:00 A.M. <br /> <br />ow~'~."'E: 09/] f/Sg TIME; 3:32:03p TAX LOT: CATEC~ORY: <br /> r~!CHA~[)S, MA¥SEL 5771!-000 RESi3 <br />SITUS ADDRESS; CONSTRUCTION TYPE: OCCUPANCY: <br /> <br /> 5-h! R,--3 <br /> 235 CLEVELAND STREET CONTRAdTCITY: uee: OOCUPANT~AD: <br /> <br /> ~',UMSV ;; L LE O~ 9?325 <br /> AUMSV [ LLE NO NO OF BEDROOMS <br />USE O¢ 6UILDING: <br /> <br />MAILING ADDRESS: ;SINGLE ?AMILY DiNELL:NGS <br /> <br /> '"., BOX ~05 <br />.,*.L MS',/] LLE (',R 97325 <br />:;>!~',.;N F:: 7 ¢ § -- 26 ] G <br /> <br />SS <br /> <br /> S;'TE NUMBER: <br /> V,& LUAT l ON: <br />RANGE: <br /> <br /> '! ?27 <br /> $1 ....... <br />ZONE: MAP: <br /> <br />NO <br /> <br />PERMIT OR APPL_~CATION NO: <br /> <br />MARK P,-s ESC:OTq <br />:MX~ EAST Pt]WELL <br />HCIN~OLr'T'H OR <br /> <br /> ,TTE~ <br /> <br />PLAN <br />:I.'FET SURCHARGE -ZONE 3 <br />E/U[LD;NG ?TA'T_F SURCHARGE <br /> <br />,~.,~YEE:: MARk;F:RE,.~CC ,¢' ~'*, <br /> <br /> 9018800 <br /> <br />i. RCH ITECT/ENGI NEER. NO_ <br /> <br />Pk;ON E: <br /> <br />TOTAL ASSESSED <br />THIS RECEIPT <br /> <br />BALANCE DU~ <br /> <br />(~UA.NT: TY <br /> <br />AMOUNT <br /> $92_~0 <br /> <br />-I: 3.0 C: <br /> <br />!,,E,_~. ;',,¢.,.,,~.,,,c"v.. ~',,_ TYPE~ IN CH.F. CK <br /> <br /> "..,. 7~ NOT A PERMIT, THIS A. PPLICATZON MUST GO THOUGH A REVIgW PROCEedS <br />:: ~- ~ q ~UST' PF <br /> )~.~ /~ ,IL ¢~ CC~PLETED. ZT ZS THE ~SPONS~BZL~TM OF THE A?>LZCANT %0 AS%L ~::. '' .¢~ <br />~_:. W, EC~S~.ARY :N¢ORMATI~ H~ ~EEN P~V~DEO. <br /> <br />S~:'?;' lC STM ............. DP'T':; <br /> <br />· '~,'-~ ~v- ~IY DATE SE-~CKS: ~-20 <br /> <br />REM.ARKS; BEDRM ORK RrfL,''--''..L_ BATHR~i <br /> <br />¢'rTv JURlfSrOICF:ON: BY <br /> <br />OFFICE COPY <br /> <br /> <br />