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MARION COUNTY BUILDING INSPECTION <br />SENA'TOR BLDG, NO, 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 588-$147 <br />CODE-A-PRONE 4:30 RM, - 8;00 A.M. <br /> <br />SIGNATURE OF APPLICANT: <br /> <br /> DATE: _ <br /> <br />ow~TF,.: 09/1 ~/89 'T'I~E: <br /> <br /> :,: .H,,h.O.~. !vlAYSEL, <br /> <br />3~32:49p <br /> <br />CATEGORY: <br /> <br />OCGUPANCY~ <br /> <br /> 285 CLEVELAND STREET <br /> % ¢., ~V[LLE OR <br />USE OF BU[LBING~ <br /> <br />9?325 <br /> <br /> CONTRACT ClTY~ <br /> <br />AUIvlSV I LLE <br /> <br />UGB: <br /> <br />NO <br /> <br />GEGUPANT LOAD: <br /> <br /> NO OF BEDROOMS <br /> <br />SUBDIVISION: <br /> <br /> ~:>O BOX !06 <br /> A.L?tSV!LLE OR 9?325 <br /> ?}'t jN E: ? 49 --~}: 6 ! 6 <br /> <br />LOI': BLOCK: <br /> <br />WIDTH DEPTH: <br /> <br />SITE NUMSER~ ~'~27 <br />~ANG~ALU.ATION:ZONS: <br /> <br />IRREG. LOT; ~¢'~ CORNbH; R~ <br /> <br />NO NO <br /> <br />MAP. <br /> <br /> :5 I <br /> <br />""YPE: ~>I_.LJ~IB <br /> <br />~E~[? OR APPLIQ~TiON NO; <br /> <br />'.]C)NTRAC'r()i-% NO. 57859 <br />hGa Rh' !;:>R EECCY <br />.',?98 EaST POWEL. L <br />!v!ONI~OU-I' ~ OR 973~ '! <br /> <br /> I'-EM <br />r~ESIOEN]'~AL FIX*YR,. ALTERATIONS <br />· ::...,..fv.BING 8ASE FEE <br />F'__EE"F SURCF[ARG~ ..-ZONE 3 <br />'~.,)v'BING STATE SURCHARGE <br /> <br /> MARK PRESCOTT <br />....:G..c~c~ ,~Y: · 8 <br /> <br />90'}8802 <br /> <br />QL;AN T Z Tv ¢ aOU k T <br /> 5 ~ 4 ...... <br /> <br /> $3. ¢_;4 <br /> <br />TOTAL ASS~SSBD FEES <br />RREVZOUSRECE;~TS <br />T~IS RECE[PS <br /> <br />$72_09 <br /> <br />BA~.ANCE DUE ¢ ~ o' <br /> <br />~NVOICE NO: 19o~2 <br />CHECK ~: O <br /> <br />* THIS IS NOT A PERHIT. THIS APPLICAT?ON MUST GO THROUGH A REVI~ P~E~ ~ERE THE <br />FOLL~ING ~ST BE ~PL~ED, tT IS ~E R~SIBILI~ OF ~E APPLIC~T TO A~RE ~AT <br />ALL NEC~RY INFO~TI~ H~ 8E~ P~VIDED_ <br /> <br />c> .,,~'.,!,1 REVIEI¢I: I~Y .......... DATE <br />RE~14o 5 PIX <br /> <br />SITTM JURISDICTION: BY ........ 0ATE ........... <br /> <br />FO~U,¢ ~c ~-~6 REV -/~e OFFICE COPY <br /> <br /> <br />