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MARION COUNTY BUILDING INSPECTION
<br />SENAT..~ BLDG, NO. 225
<br />220',~SHSTREET NE
<br /> SALEM. OREGON 97301
<br />
<br /> PHONE 588-5147
<br />CODE-A-PHONE 4:30 P.M, - 8;00 A.M,
<br />
<br /> I am performing work on 8 property I own or occupy
<br />lam a reg~stered builder OR he au horzed ep esen ave
<br /> of a reEls,toted builder,
<br />The work will be periormed by a registered builder.
<br />Other__
<br />I have read and agree to the terms stated on the reverse aide of
<br />
<br /> DATE: 02/!8/88 'r'~ME-,=, _~'~:82;25~ ,
<br />OWNER: ; TAX LOT:
<br /> COAKLEY, RODNEY & mARiA
<br />
<br /> I CATEGORY:
<br />
<br /> ', 58055-00,) × ........ ,,.~ ,.
<br />
<br /> 5?85 SHA.I/~ F..~v i CONTRACT CITY; j UGh: ~5~0~ L~AD;
<br /> .I.U~SV; LLE OR 97325 i j
<br />
<br /> :N0 0F BEB~0OMS:
<br />
<br />MA~LJNG ADDRESS: ~ESZ DENTZAL ACC~SO~Y S'TRUCTUR~S SU~6iV~S~ON;
<br />
<br /> 185 =,LLFER ¢'' 1', ' LANE SO
<br /> SA.L E~'4 9?802
<br /> RHCNE: 362-650;3 SITE NUMBER¢ 3193
<br /> VALUATION
<br />
<br /> 4.90000 '
<br />
<br />TYPE: BUILDING PERMIT OR .APPL. 7, CATZON NO:
<br />
<br />CONTRAC ~ OR. NO,
<br />.C. GAKL~Y. RODNEY & MARIA
<br />185 CULV~R LANE SO
<br />3,A~. EM 97302
<br />PHONE: 382-,%508
<br />
<br />~UILDZ;WG FEE
<br />P~AN REVI~,N
<br />F'LEET SURCHARGE -ZONE 3
<br />8LiIL. DING STATE %URCHARGE
<br />~GNING SURCHARGE
<br />
<br /> 8727
<br />ARCHITECT/ENGINEER, NO.
<br />
<br />PHOI',i E:
<br />
<br />QUAN,.,~Y
<br />
<br />~ OT,,~L A$SESSEP FEES
<br />rREV,I, OUS RECE 7. PTS
<br />T'H t,S RECEIPT
<br />
<br />23.7,3
<br />23.73
<br />$ 2. ,2 S
<br />
<br />,LANCE L,J~ t' ',,',
<br />
<br />PAYEE:
<br />'~ECE;VE3 3Y: mb TYPE: CHECK ,~:
<br />*: '"%,[S iS A VALID PERMIT ~ THIS PER~IT EXPIRES 180 DAYS FRO~ !TS ISSUE CATE,
<br />CONSTRLJCT'ION CEASES FOR ~ PER[CE OF 188 ~AYS OR IF ~'~" ¢~' '
<br /> O~S Rd~, ~ON FALLS *'0 Mb'ET ,t. ....
<br />RI;OU;REHENTS OF 3%ATE LAwS~ AND ~ARZON 'C~NTY BUZLDZ'NG'.A.ND ~CN NG ORO.N,,~NCE,., .-.,
<br />SHAL~'_ BECOME NLJL. L. AND VOID.
<br />
<br /> 2~M./~,F~KS: POLE BLDG DIRT FLOO:<~
<br />
<br />F('~HM , MC 15-56 RFV 6/87 OFFICE COPY
<br />
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