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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 rogistered buifderOR( beau horzed ep esena ~e <br />of ~ registered builder, <br />The work wdl be perfoH~ed b'~ a rogistored builder <br />Othor__ <br /> <br />I hape read and agree to the terms stated on the reverse Side of <br />th~,~ document <br /> <br />SIGNATURE OF APPUCANT <br /> DATE <br /> <br /> 07/02/91 <br /> <br /> NAT J'ONAL FOREST LANDS <br /> <br /> HALLS RI DGE ~U~NI T SE CONTRACT CITY UG~ <br /> OR <br /> <br />BUILDINO ,MARt~ ~NTY NO <br /> <br />MAILING ADbRESS PUt, LiD WORK5 AND U¥ILITIES 8UILOlh~wS~ON <br /> <br />DETR_RNGR BC60 BOX 320 MiLL CiTY <br />SNR NEf~)RK 1628 N~ ~VEREfT PORfLNO <br />PHONE: 228-2252 <br /> <br />SiT~ <br /> VALUA f ,f ON: <br /> <br /> 08 )0 <br />WIDTH DEPTH AREA UNITS IAREG LOT <br /> <br />CATEGORY <br /> <br /> L;OMM ~ kx21 AL <br /> <br /> 1304,9 <br />$22,500_00 <br /> <br />5E TC 'f 04 <br /> CORNER <br /> <br /> NO NO <br /> <br />IYPE ~U[LOiNG PERMIT OR APPLICAFiON NO: <br /> <br /> I rEM <br />FCU iLDING FEb. <br />PLAN REViEt4 <br />,~UJ, L01NG STAI E 5URCHAR(_,iE <br />ZONING SU R(..~HARG~ <br /> <br /> 32412 <br />ARCH~f~CT/gNGiN~BR, NO_ <br /> <br />PHONg: <br /> <br />TOTAL ASSESSEO FEE5 <br />PREVIOUS RECEIPrS <br /> <br />QUANTITY <br /> <br />$103,~3 <br /> $~ ~ <br /> <br />$2]!,39 <br />$27'?.39 <br /> Su_ oD <br /> <br />BALANCE DUE <br /> <br /> RECEIVED BY: P8 TYPE; CBECK <br /> <br />* THIS IS A VALID P~RMIT ~ ~HI~ P~RMi] EXPIRE5 180 DAYS PROM ItS ~U~ <br />CONSIRUOIION CEASES FOR A PERIOD OF ~80 DAYS, OR IF CONSFRUCflON FAIL5 fO ME~f ALL. <br />RgQUiRE~ENiS OF 5IAJE LAN5 AND ~ARiON COUNIY BUiLDiNG AND ZONING ORDINANCES, <br />!~ALL BgCOMt NULL AND VOID.. <br /> <br />591 -SACKS: <br />REMAR~: <br /> <br />HE i~HT; <br /> <br />DON/iLO E_ <br /> <br />PRbFABRtCATED OOMMUNICA[ZON MODOLE'~R~b55~ <br /> <br /> IOIAL ~) Fl: O STORIES: <br /> <br /> MARION COUNIY ~UiLDiNG OFFiCiAL / BY <br /> <br />PLAN.AC¥iON: <br /> <br />FORM ~ MC 15 56 REV 4/90 OFFICE COPY <br /> <br /> <br />