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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 />t om porforrnirl§ work on a property I own or occupy. <br /> <br /> DA'rE: 12/03/91 TZMEz 16z19:49 <br /> ~J f' f'ER, RALPH <br />SITUS ADDRESS <br /> <br /> 830 9TH 8'r <br />AU/vlSViLLE <br /> <br />SIGNATURE OF APPLICANT: <br /> <br />DATE: <br /> <br /> 90040-250 <br /> OONSTRUCTION TYPE; <br /> 5-N <br /> <br />OR 9?325 <br /> AUI~cVI LEE N0 <br /> <br />SINGLE F/~41L¥ <br /> <br />DEL MAR 11i <br /> <br />CATEGORY: <br /> RESi DENI' l~a~_ <br />OCCUPANCY: <br /> <br />OCCUPANT LOAD: <br /> <br />3 <br /> <br /> PHONE ~. <br /> <br />LOT: BLOCK: SECTfON: <br /> 12 5 25 8~ <br /> ?5 1 O0 7500. SF' <br /> <br />SITE NUMBER: 15041 <br />VALUATION: $45,000.00 <br /> <br /> 2N ~ <br /> NO NO <br /> <br />'TYPE: DNELLING PEAT4tT OR APPLICATION NO: <br /> <br />CONI'RACI'OR. NO. 43505 <br />Pa'ICh L Sutter <br />PO Box 12533 <br />S~']ecn, 97309-0000 <br />PHONE: 588-2373 <br /> <br /> I'FE¢4 <br />0~ELLING BUILDING FEE <br />O~IELLiNG PLUNBING <br />[}NELLIN6 MECHANICAL <br />~NELLING ELECTRICAL <br />~ELLING STATE ~HA~E <br />~ELLiNG P~ REViE~ <br /> <br /> 9037173 DP <br />ARCHII'ECI'/ENGINEER, NO. <br /> <br />TOTAL A..SSE. S.SED FEP.~ <br />PRE¥iOU$ RECEIPTS <br />THiS RECEIPT <br /> <br />QUANTITY <br /> <br />/~JN'I' <br /> $213.19 <br /> ~'17,74 <br /> 19-37 <br /> $60.70 <br /> $18.55 <br /> $185.00 <br /> <br />$574.55 <br /> $0.00 <br />$574.55 <br /> <br />BALANCE DUE $0.00 <br /> <br /> PAYEE; Ra'lp~ L ~iutter ,Y¢~/am/~ 29123 <br /> RECEIVED BY. PS TYPE- i'N CHECK ~: 0 <br />· 'fH18 I~ NOT A PERMIT. THIS APPLiCATioN I~UST 60 TH~ A REVIEW P~ ~ERE THE <br />FOLL~ING MUST BE ~PLETED.+ iT iS THE R~5iBILITY OF THE APPLiC~T TO ~RE THAT <br />ALL N~RY iNFO~TI~ H~ BE~ P~IOED. <br /> <br />CiTY JURiSDiCTION: 8Y ............................. DATE ................................ <br /> <br />SEPTIC: BY DATE <br /> <br />ZONING: BY DATE SE'fBACK$~ ER 20 LS <br />RP3YIARF.~: NE'N'"'RE.S ............................................... <br /> <br />HEIGHT; 'TO'TAL SQ Fl': 1325 STORIES: <br /> <br />RS 5 RR 5 SP <br /> <br />PLAN.ACI'iON: <br /> <br /> OFFICE COPY <br />FORM ~ MC 15-56 REV. 4/90 <br /> <br /> <br />