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MARION COtJNTY 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 /> I an/ a registered builder OR the authorized represen a ye <br /> ofaregls ered bu der, <br /> The work will be performed by a registered buiider. <br /> Other <br /> I ~ave read and agree to the terms stated on the reverse SMO of <br /> this document. <br /> <br /> DA'rE= 05/'31/91 ;rtl'dE= 11=03:48 <br />OWNER; <br /> HARRIS, HOWARD <br />$~TUS AODFIESS <br /> <br /> 205 2NO S'f' N <br /> AUMSVILLE OR 9?325 <br /> <br />USE OF BUiLDINg; <br /> <br />TAX LOT~ <br /> <br /> ~ONSTRUCTION TYP~; <br /> 5,,,,N <br /> <br />'Aur4Sv~ LLE <br /> <br />NO <br /> <br />CATEGORY: <br /> RESI DEN'I <br /> <br />OCCUPANT LOAD: <br /> <br />MAILING ADGF~ESS: RESIOP.~N'I'IAL A(;YC~R¥ '~'FRtCIS.:FMRES .Su~G~wstoa: <br /> <br />PO BOX ?52 <br />AUMC~VILLE OR 9?325 <br />PHONE: 749-3726 <br /> <br /> SiTE NUMBER: <br /> VALUATI(:~N: <br />RANGE: <br /> <br /> 12'765 <br /> <br />ZONE~ MAP: <br /> <br />uni+s: <br /> <br />IRREG LOT: 'CORNER: <br /> NO NO <br /> <br />TYPE: BUILDING PERNi'I' OR APPLiCATiON NO: <br /> <br />CONTRACTOR, NO. 25902 <br />~'rEYEN NiC~OL <br />12164 W. S'I'AYI'ON RB SE <br />AUtclSVILLE OR 9?325 <br />PHONE: '~69-2989 <br /> <br /> I'f'EN <br />BUILDING FEE <br />PLAN Rg¥1EW <br />BUILDING 5'I'A'T'E SURCHARGE <br /> <br /> 9032593 <br />ARCHiTECT/ENGINEER, NO. <br /> <br />QUANTITY <br /> <br />'[OTAL ASS~ED FEES <br />PREVir. XJS RECEIPTS <br />THiS RECEIPT <br /> <br /> BALANCE DUE <br /> <br /> PAYEE: ~'[EVbN NICHOL <br /> RECEiVEO BY: PR .................. ~-..., ........... ~ .......................... TYPE: iN CHECK ~; <br />~ 'fBi~ iS NO'T A PERMIT. :TH18 APPbtOA~ioN;MUST: 60 THROUGH A REVIEN PROCESS WHERE THE <br />FOLLOWING MUST BE OOf4PLET~D;:,:i,T I~ THERC-~PONSIBiLITY OF, THE APPLICANT 'rD AE~AIRE rHA'I <br />ALL NECg~ARY INFORMA~ioNHAS:BEEN PROVIDED, <br /> <br /> $80.50 <br /> $52.33 <br /> $4.03 <br /> <br /> $126.86 <br /> $o.0o <br /> $136.86 <br /> <br /> So.oD <br /> <br />343§~ <br /> 0 <br /> <br /> CiTY JURISDICTION: BY ................................ OA'I'E <br />SEPTIC: BY BATE <br /> <br />ZONING: BY BATE .............................. SETBACKS: FR 20 LS 5 RS 20 RR 5 SP <br />R~RF,.S~ GA, PAGE .............. - .................... <br /> <br />HEiG~'I'; 12 TOTAL SQP'T: 768 STORIE,,~: 1 PLAN.ACTiON: <br /> <br />OFFICE COPY <br /> <br /> <br />