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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO, 225 <br />220 HIGH STR~::ET NE <br /> SALEM, OREGON 97301 <br /> <br />I am performing work on a property ~ own or occupy. <br />lam a registered builder OR( )thes~horlzed representative <br />of u registered builder, <br />The work will be performed by a registered builder. <br />Other. <br /> <br /> PHONE ~88-5147 <br />CODE-A-PH _~,NE 4-~.BO P.M. - 8:00 A.M. <br /> <br /> SIGNATURE OF APPLICANT: <br /> <br />GRIM, WARREN & JEAN <br /> <br />3: 50: 30P ~ ~,x 'C5~i .................................................. <br /> <br /> 20888 HUBBARD CUT OFF RD NE <br /> AURORA OR 97002 <br />:USE OF BUILDING: <br /> <br />MAILIN(~ ADDRESS: SINGLE 'FAMILY D~ELLINGS <br /> <br />~ARION COUNTY NO :~ <br /> <br />'18598 NIGHWAY 99E NE <br />HUBBARD OR 9?032 <br />PHONE: 982-34~3 <br /> <br />4.26000 <br /> <br /> SITE NUMBER: 5185 <br /> VALUATION: $.~ .~..9,.:~.~ ._.0~) ......... <br /> <br />4S IN E~U ....... : ...... 3 ............... , <br /> IRREG. Lei: CORNER: <br />AC NO i NO <br /> <br />TYPE: BUILDING PERMIT OR APPLICATION NO; <br /> <br />CONTRACTOR. NO_ <br />GRIM, WARREN & JEAN <br />18598 HIGHWAY 99E NE <br />HUBBARD OR 97032 <br />PHONE: 982-3433 <br /> <br /> ITEM <br />BUILDING FEE <br />PLAN REVIEW <br />FLEET SURCHARGE -ZONE 6 <br />BUILDING STATE SURCHARGE <br />ZONING SURCHARGE <br /> <br />10409 <br /> <br />ARCHITECT/ENGINEER, NO. MASCORD <br />~ASCORD, ALAN <br />1515 NW 29RD AVE <br />PORTLAND OR 97210 <br />PHONE: 225.~9181 <br /> <br />QU.AN T I TY <br /> <br />TOTAL A~ESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />AHOUNT <br /> $298_00 <br /> $I93.?0 <br /> <br /> $14.90 <br /> $14.90 <br /> <br />$529.18 <br />$529.18 <br /> $0.00 <br /> <br />BALANCE DUE $0.00 <br /> <br />PAYEE: <br />RECEIVED BY: PB TYPE; CHECK <br /> <br />:+: THiS iS A VALID PERMIT ~ THIS PERMIT EXPIRES 180 BAYS FROM ITS ISSUE DATE. IF <br />CONSTRUCTION CEASES FOR A PERIOD OF 180 DAYS, OR IF CONSTRUCTION FAIL~$ TO MEET ALL <br />REQUIREMENTS OF STATE L.Ak. LSANB MARION COUNTY BUILDING AND ZONING ORDINANCES, THIS PERMIT <br />SHALL, BECONIE NULL AND VOID. <br /> <br />SETBACKS: FR-20 LS~I0 RS-l?5 RR-230 <br /> <br />RE."JvIARKS~ NEW RES R~4408 <br />HEIGHT: 14 TOTAL SQ FT: 2416 STORIES: i <br /> <br />DONALD E. WOODLEY. MARION C, OU~TY BUILDING OFFICIAL / BY <br /> <br />OFFICE COPY <br /> <br /> <br />