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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, - B:O0 A.M.
<br />
<br />The work wilt be per~ormect by a registered builder,
<br />Other
<br />
<br />©AT~: 07/14/87 'T iI~E:
<br />O~VNERZ , TAX LOT:
<br /> ,3OOCARD. SAM & ROSE 5535
<br />
<br /> 852; HO LI!V<&J ]', Si'"
<br /> O,L, co'NTR~CT Ol~: i IJSit; OCCuPANt LOAD:
<br />.-,,_ ,,,-~v, ,,.,.,
<br /> , ,,
<br />
<br />MAILING ADORESS:
<br />
<br />WIDTH; DEPTH:
<br />
<br />SUBDIVISION;
<br />
<br /> SiTE NUMBER:
<br /> VA~..LJ.A, .,ON t
<br />
<br />85000 ', AC NO
<br />
<br />] 9 ,'3 g
<br />
<br />TYPE: :~LECTR [CAL
<br />
<br />CUNT P~..CTOR,
<br />_',r CEhiS(~ NO;
<br />
<br />39':'7 ;8ER~S ST NE
<br />SAL_E~: OR 9?305
<br />PPiCiXE: 393-5714
<br />
<br />P,,.-7,,RMi7 OR APPL,]CAT.[ON NO: 9003221
<br /> SU P~.RV i,~. N,--~
<br />
<br /> ~A,~ & - '-
<br />PAY~.(:., GFdUE)AR[;, '"' t4OS=.
<br />'x _,_,m ~ V... U ,.,"' ' ¢'~
<br />
<br />* THIS f$ NOT A PF~iT. THiS
<br />FOLLONING tc/JST ]BE COr4PLETED_
<br />ALL NECESS&RY ]NPOFO'IATIQN
<br />
<br />OUAN T Z ~Y &Y!CUN T'
<br /> $2::.
<br />
<br />TOTAL ASSESSED FEES
<br />PREVIOUS RECE;PTS
<br />THIS RECEIPT
<br />
<br />3AL,~CE CUE
<br />
<br />¢':" 93
<br />
<br />REC;g~PT N(3: '"'='"'~, ;,
<br />
<br />A REVIEW P~iOCESS WHERE THE
<br /> THE APPLICANT TO ASSURE '7~,.Z, ,?
<br />
<br />OFFICE COPY
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