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MARION COUNTY BUILDING INSPECTION <br /> SENATOR BLDG, NO. 225 <br /> 220 HIGH STREET NE <br /> SALEM, OREGON. 9'2301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br /> 24 HOUR CODE-A-PHONE: 588-7904 ~ <br /> <br />I am a registered builder OR the authorized repreaentative SIGNATURE OF APRLF <br />of a registered bdllder, <br />OtherThe w°rk will be ped°rmed by a registered builder' ......... <br />I have read ~hd ~cj~ to the terms stated on the reverse side Ct DATE: <br /> <br /> DATE.* 10/30/90 TIME: 12:06:59 <br />owN~n: TAX t. OT, <br /> KLEIN, LARRY Rrg~ I OEN;'r I AL <br /> <br /> 5-N <br /> 9804 MILL CREEK RD ~E CONTRACT CITY: gGB: j OCCUPANT LOAD: <br /> AU~V~ LLE OR 97~25 <br /> ~ARJON ~N'I'Y NO <br /> <br /> VALUAT ~ ~: $ O, O0 <br /> <br /> 31 8S '1W EP~ 48 <br />WIDTH: ;GEPTH: AREA: 13. UNITS: AC IRREG. LOT: NO GORN~o <br /> <br />TYPE: BUILDING <br /> <br />CONTRACTOR, NO. <br />KLE~N, LARRY <br /> <br />PERNi'f' OR APPLICATION NO: <br /> <br /> go28&20 <br />ARCHiTECT/ENGINEER, NO. <br /> <br />f,c'HONEt 749-2405 <br /> <br /> ! 'rEM <br />ADDITIONAL BUILDING FEES <br />FLEET ~,JRCHARGE -ZONE 3 <br />BUILDING fS'I'A'i'E ~A~E <br />Z~ING ~HA~E <br /> <br />TOTAL ~ES~ED F'E~ <br />PRE¥iOU~ RECEIP'rS <br />THiS RECEIPT <br /> <br />~ALANCE OUE <br /> <br />QUANTITY <br /> <br />AI~.JUN'r <br /> $~5,00 <br /> $~.84 <br /> ~0.50 <br /> 0.50 <br /> <br /> ~0.00 <br /> $39.84 <br /> <br /> $o,oo <br /> <br /> PAYEE: KLEIN, LARRY ~/~ , 30024 <br /> RECEIVED BY: ~ ......................................... i._.....~._._,._,..,~,. ............................... TYPE: CK CHECK ~t 1828 <br />· '['Hi~ t~ NOT' A PERMIT'+ 'rills APPLiCATiON MU~'r 60 THROUGH A R~/IEW PROC.~ ~ERE THE <br />F'OLL~ING ~S'[' BE ~PLEI'ED. IT iS THE R~NSIBiLI'I'Y OF THE APPLICANT TO A~]RE THAT <br />ALL NEC~RY INFO~ATi~ H~ BE~ P~VlDED. <br /> <br />CITY JURISDICTION: BY ........................... DATE ................................ <br /> <br />SEPTIC: ~Y DATE <br /> <br />RE'~R~: ~RG:'~O~ TO'"'BE'"OSED ~ A F'~SHJNG"P~N'f' 3"~TRS A'"YEAR .............. <br />HEiGHI; TOTAL ~ FT: 2088 <br /> <br />OFFICE COPY <br /> <br /> <br />