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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 /> The work wHI be performed by a registered builder. <br /> <br />D.ATE: 0]/]0/8? T;~cE_, t, ~ ~:55a"'~ <br /> <br />SITUS <br /> <br /> ~ ;.! <br /> <br />NE <br /> <br />SIGNATURE OF APPLICANT: <br /> DATE'. <br /> <br /> CONTRACT CITY: UGB: <br />~.R i ON COUNTY ; NO <br /> <br />G~EGORY; <br /> <br />OCCUPANCY: <br /> <br />MAILING AODR~SS: ~ -~l~ ~U~DIVI~ION: <br /> ;;4 dAxD .... OFF ~48 - DYKE <br /> <br /> ~ ~ VALUAT T ON <br />WIDTH; DEPTH: AREA: q O0 _ 00d ' UNITS: <br /> Y:>F:;~ ~SZLE HOME ~ERMIT OR A, P~..,.¢.~..ON NO: 2816 <br /> <br /> ..... QUANT <br /> PaC)8]L.E:,'H~Ea FIRS]" ~iDTH <br /> i~-S:L 5 HQME PLANS REVIEK FEE <br /> <br />OCCUPANT LOAG: <br /> <br /> 2 <br /> <br />,,., A= ASSESSED FEES <br />2'REVIOUS <br />TU'Fe RECEIPT <br /> <br />$45.83 <br />$ 4 5, ,3 ,: <br /> $0 0C <br /> <br />8AL,~CF._ DUE: $0. ,55 <br /> <br /> iNVOICE NO; <br />TYPE: ,..,H ~*,.K ;~ ,' <br /> <br /> THIS IS A VAL]:D f>ER~IT ~ THIS <br />COf4ST,RUCTION CEA. SEE5 FOR A <br />REQUiREmENTS OF STATE ~ AND <br />5HALL BECOf~E NULL AND VOID. <br /> <br />FRO~4 ITS iSSUE DATE. IF <br /> FAILS TO NEET ALL <br /> ORDINANCES, THIS PE~,iT <br /> <br />OFFICE COPY <br /> <br /> <br />