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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: 888-8147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> I am performi~9 work on a property t own or occupy. <br /> rarn a registered builder OR { ) the 8uthodzed representative <br /> <br /> OA'f E ~ 10/29/91 TIME: <br />OWNER: <br /> FAULKNER, <br /> <br /> 235 'fEN eT <br />AUMSVi LLE OR 9?325 <br /> <br />USE OF BUILDING: <br /> <br />SIGNATURE OF APPLICANT: <br /> <br /> 5??06-OOO <br /> <br /> CONSTRUCTION TYPEz OCCUPANCY: <br /> 5-N I'~ 1 <br />3 2 ~c,~-rn,~f' di:ry~ u~: ~cvPANf LEAP: <br />:AUiV$SVi LLE NO i <br /> <br /> PO BOX 84 <br /> ALBANY OR 9'1321 <br /> <br /> VALUA'f ION: $2,800,00 <br /> <br />LOT: : 8LOCK: SECTION: T~WNSHiP~ RA~E: ~O~E~ MAP: <br />: 32 25 8S 2~ ', ~ <br /> , , sF YES %o <br /> .. ,:, ::'.: <br /> <br />RES I OEN T!AL ACCE~RY $'f'RUCTURES <br /> gU BeivISION: <br /> EVERGREEN MOf~iLE ESr'Al'E5 <br /> <br />RESIDENIiAL <br /> <br />'IYPE: BUILDING PERMIT OR APPLiCATiON NO: <br /> <br />CONTRACTOR, NO. S8238 <br /> <br />1'I373 Nlff"l"l Creek Rd <br />Aumsvil'l~, 9?325-0000 <br />PHONE: 769-'1744 <br /> <br /> I'fE~ <br />BUiLDiNG FEE <br />PLAN REVIEW <br />BUILDING STATE SURCHARGE <br /> <br /> 9036429 <br />ARCHt'T'ECT/ENG[NEER, NO. <br /> <br />TOTAL ~E~ED F'EE~ <br />PREVIOUS RECEIPTS <br />'fHiS RECEIPT <br /> <br />OUANT [ I'Y <br /> <br />AIvK~UNI <br /> $38.50 <br /> $25.03 <br /> $~-93 <br /> <br />$65,4.6 <br /> $0.00 <br />$65.46 <br /> <br />8ALANE;,E OUE if.), O0 <br /> <br /> RECEIVEO BY: P8~'"/: TYPE: iN CHECK ~: 0 <br />* THIS iS NOT A PERM~'f'. 'THIS APPLICATION NUS'f GO THROUGH A REVIEW PROCESS WHERE THE <br />FOLLOWING ¢¢1LI5'l' BE 03¢4PLEf'EO. ~'1 ~ THE R~PONSiBiLI'f'Y OF FHE APPLICANT FO ~URE 'fHA'? <br />,ALL NECE~ARY INPOR~A'f'iON HAS BEEN PROV~OED. <br /> <br /> C,~'T'Y JURISDICTION; BY ................................ ~)AIf'~,' ............... <br />SERTiC! E~Y ................................................ OA'f'E .............................................. <br /> <br />ZONING: BY DATE ................................... <br />RE,lARKS: CARi~ORT ............................. <br /> <br />~-tE:.[(3H'~': ~,2 TOTAL ~ FT: <br /> <br />OFFICE COPY <br /> <br /> <br />