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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 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am performln9 work on a property I own or occupy <br />l am ~ registered builder OR ( ) the authorized representative <br />of a registered builder. <br />The work will be performed by 8 registered builder, <br />Other <br /> <br />SIGNATURE OF APPLICANT: <br /> DATE: <br /> <br />08/10/90 1' ];NIE: 13:00:14 <br /> <br />TAX t, OT: CA FEGORY: <br /> <br /> 9rJOS0-B20 <br />CONSTRUCTION TYPE: OCCUPANCY: <br /> <br />RESiDENTiAL <br /> <br /> 21:3 5TN ~f' <br /> AUt'~VI LLE <br />USE OF BUILDING: <br /> <br /> CONTRACT CITY: <br /> OR 9?325 <br />........ ALIF'a~V I LL.E <br /> <br />NO¸ <br /> <br />OCCUPANT L~'kS:! <br /> <br /> NO OF BEDROOMS <br /> <br />MAILING A~O~ESS: RESID~N:f ~AL X~ S'f~C'i'UR~ i ~UBDIVImON; <br /> <br />PO BOX 9'72 <br />Aur4sVILLE OR 9?325 <br />PHONE: '?49-1401 <br /> <br /> MERRIF~EL~S AODiltON <br /> <br />~i'T'E NUMBER: 10928 <br />nA~LUA'f'ION: zone: $3,872.0~A¢: <br /> <br />WIDTH: 5 ;DEPTH: 1 ix~EA~ ~5 UNITS: 9S 'IRREG. L©T: 2~ CORNER: RM 51 <br /> 108; 97 : 10476. SF NO YES <br /> <br />TYPE: BUILDING PERCcli'F OR APPLICATION NO: 9026~42 <br /> <br />CONTRACTOR, NO+ <br />HOOVER,, LARRY <br />PO BOX 9?2 <br />AUffI~V I LLE OR 97325 <br />PHONE: 749-']401 <br /> <br />ARO~IT'EC'I'/ENGiN~ER, NO. <br />PHONE; <br /> <br /> ITEM <br />BUILDING FEE <br />PLAN RE¥1E~ <br />FLEE'I SURCHARGE -ZONE 3 <br />BUILDING ~'FA'FE SURCHARGE <br /> <br />QLJANIi'I'Y <br /> <br /> 'fOTAL A.B.~E'S~ED FEES <br />PRE¥iOU8 RF. JCEiPI'8 <br /> RECEIPT <br /> <br />AMOUNI <br /> $44,50 <br /> $28,93 <br /> <br /> $2,23 <br /> <br />$?9,50 <br /> $o,oo <br />$?9_50 <br /> <br />BAI_~J'4CE DUE $0_00 <br /> <br />PAYEE: HOOVER, LARRY <br />RECEIVED BY: PB ............................. ;; ........... ;, ............................... <br /> <br /> 2?894 <br />TYPE: iN CHECK ~: 0 <br /> <br />:~ 'fHiS I'..5' NOT A PERP,'Ii')". THIS: APPLICATION ('¢IUS'f' r.,.-.-.-.-.-.-.-.-~O I~"N~{,~,}U(,~"~ A REVIEW PROCE~ I~HER¢2: 1H~ <br />FOLLONiNG MUS1 8E COf¢]PLETED., ,~T, J;S THE RESPONSiBILiTY OF THE APPLiCAN'f' TO A~RE IHAf <br />ALL NECE~:SARY iNFOF;~4AI"ION HAS BEEN PROVfOEO. <br /> <br />CiTY JURiSDiCI'IOI',h BY <br /> <br />SEP'flC: BY DATE <br /> <br />ZONING: 81 DATE SE'I'SACK~: FR 10 LS.fl0 <br />REI'4ARKS: GARAGE'"'AEREADY PART%AE£? 8UtL'f .... ' <br /> <br />HEIGHF: 9 TOTAL ~ ET: 432 ~'TORi~ '1 <br /> <br />OAI'E <br /> <br />PLAN-AC'lION: <br /> <br /> OFF[CECOPY <br />FORM # MC 15.56 REV. 4/90 <br /> <br /> <br />