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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 performing work on a property I own or occupy <br /> lama registered builder ORr ~theauthorlzed representative <br /> of a registered builder, <br /> The work will be performed by a registered buiJder <br /> Of her <br /> I hare read and agree to the terms stated on the reverse side of <br /> th~$ document <br /> <br /> SENORN, DAVID L. <br />SITUS AODRES$ <br /> <br /> 190 ~, PIPFH ST <br />AU~VI LLb OR 9?325 <br /> <br /> fAX LOT <br /> 57693-00 <br /> CONSTRUCTION TYPE <br /> 5-N <br /> CONTRACT CITY UGB <br /> <br />AU~SVJ. LIE, NO <br /> <br />I'~,P.,S I DEN T iAL <br /> <br />MAIL, lNG ADDRESS RESIDP.3'4ftAL ACC~RY SFRUCfURE3 SLIDDIVlSION <br /> <br />P.O. SOX 4?3 <br />AUTCI~V l LIE <br />PHONE: 749-1440 <br /> <br />74 14 ? <br /> <br /> SIIE NUIVlBER: 12555 <br /> VALUAI2ON; $?,500-00 <br />SECTION TOWNSHIP RANGE ZONE MAP <br /> <br /> 25 85 2N C <br /> 3F YE3 NO <br /> <br />lYRe; ¢U~LU[NG <br /> <br />CONfRACFOR, NO. <br />3ENORN, 0AVID L. <br />P.O. 80X 4?3 <br />AUf~fsV~LL~ <br />PHONE: 749-1440 <br /> <br />PSk-'f4II OR APPLiCATiON NO: 31056 <br /> ARCHirECF/E~GiNEER, NO. <br /> <br />BUJLDING 3fArE SURCHARGE <br /> <br />tOtAL ASSE~EO FEES <br />PREVIOUS RECEiPtS <br />FHJS RECEIPt <br /> <br />$116.46 <br />$198-06 <br /> <br />BALANCE DUE $0.00 <br /> <br />PAYEE: 5ENORN, DAVID L. 34190 <br />RECEIVED BY: CL lYRE; IN CHgCK ~: 0 <br /> <br />* fi.ti5 15 A VALID PERivll'l ~ 'THIS PgklVllT EXPIRES 180 DAYS Ek-'O~ IfS i~E BALE. iF <br />UONSIRUCTiON CE.,A~ES POR A PER~OD OF 180 DAYS, OR iF CONSFk-XJCFtON FAiL~ IQ ~EEf ALL. <br />REQULRE~ENIS OF Sf'Af'~ LAVES AND ~R~ON COUNTY BU~LDiN6 AND ZONiNG ORDiNANCe, IH~ PERN~f <br />SHALL BECOME NULL AND VO~0. <br /> <br />~IBACKS: PR 20 LS 5 ~ 5 RR 5 SP <br />RENARKS; RV STORAGE'POLE BLDG / VALOAT~ON CHG PER Jt~ 5-23-91 <br /> <br />H~IGHI: TOTAL ~ FT: 1280 SfORIB~: 1 PLAN.ACTION: <br /> <br />CKONALO E. ~3OOLE¥, NIARION Cf.~SNf'Y BUtLOiNG OFPICtAL / BY <br /> <br /> OFFICECOPY <br />FORM # MC 15-~e REV <br /> <br /> <br />