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MARION COUNTY BUILDING INSPECTION <br />SENATORBLDG NO 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONE 430 P M - 8::00 AM <br /> <br /> I have read a¢~'"~"~t~.~.e to the terms s[~dod on the r,'~erse side of <br /> <br />DATE: 11/02/88 TIME: 10:53:08a <br /> DORAN, TOM <br /> <br /> 935 8TH <br />AUMSVI LLE OR 9?325 <br /> <br />USE OF BUILDING <br /> <br />MAltING ADDRESS SINGLE FAMILY DWELLINGS <br /> <br />PO BOX /85 <br />SUBLIMITY OR 97385 <br />PHONE¢ 769-7364 <br /> <br />I CT Ri OCK SECTION TOWNSHIP <br /> 2? 5 25 <br /> 74 79 5846. O0 <br /> <br />SIGNAIURE CE APPLICANT <br /> <br />DATE <br /> <br />TAX LOT <br /> 9O940-400 <br />CONS~ RUCTION TYPE <br /> 5-N <br />CONTRACT C~FY UGB <br />AUMSVI LLE NO <br /> <br />SUBDI¥~SION <br /> <br />DEL MAR III <br /> <br /> SITE NUMBER: <br /> VALUAT ION: <br /> <br />8S 2W <br />SF NO <br /> <br />CATEGORY <br /> RESTDENTIAL <br /> <br /> R-3 <br /> <br /> 5908 <br /> $32,500.00 <br />ZON6 MAP <br /> <br /> RS 51 <br /> NO <br /> <br />TYPE: BUILDING PERMIT OR APPLICATION NO= <br /> <br />CONTRACTOR, NO. 55493 <br />TOM DORAN <br />PO BOX 185 <br />SUBLIMITY 9?385 <br />PtiONE: ?69-7384 <br /> <br /> ITEH <br />BUILDING FEE <br />PLAN REVIEW <br />FLEET SURCHARGE -ZONE 3 <br />BUILDING STATE SURCHARGE <br /> <br /> 90122?4 <br />ARCHITECT/ENGINEER, <br /> <br />I:~ONE: <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />PAYEE: TC¢4 BOP, AN <br />RECEIVED BY: P8 <br /> <br /> .~//BALANCE DUE <br />........ TYPE: IN <br /> <br />NO- <br /> <br />QUANTITY AMOUNT <br /> $206.50 <br /> $134.23 <br /> $3.84 <br /> $10.33 <br /> <br /> $354_90 <br /> $o.oo <br /> $354.90 <br /> <br /> $o.oo <br /> <br /> 13032 <br />CHECK ~: O <br /> <br /> THIS IS NOT A PERf4IT_ THIS APPLICATION MUST C¢3 THROUGH A REVI~'N PROC~S WHERE THE <br />POLLOWING MUST BE COMPLETED. IT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT <br /> <br />ALL NEC~ARY INFORMATION H~ BEEN PRlOVIDED. <br /> <br />SEPTIC: 8Y - DATE <br />ZONING: BY ......... DATE ......... <br /> <br />REMARKS: NEW RES <br />HEIGHT: 14 TOTAL SQ FT: <br /> <br /> CITY JURISDICTION: BY <br /> <br />SETBACKS: FR-20 LS-5 RS-5 RR-5 <br /> <br />1328 STORIES: 1 PLAN.ACTION: <br /> <br />DATE <br /> <br />OFFICE COPY <br /> <br /> <br />