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MARION COUNTY BUILDING INSPECTION <br />SENATORBLDG 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: 580-7904 <br /> <br />of a registered builder <br /> <br />have read and agree to the terms stated on the reverse side of <br />this document <br /> <br /> EtA'rE: 03/19/92 TINE,+ 13:03:53 <br />OWNER TAX LOT CATEGORY <br /> H ILL~, GERALD 90222-620 RESIDEN I IAI <br />SITUS ADDRESS CONSTRUCTION TYPE OCCUPANCY <br /> 5-N <br /> ~70 N BUFFS; mw DONTRACTDITY UGB OCCUPANT LOAD <br /> mErROi'~ OR 97342 <br /> .......... DETRO1] ND <br /> <br />USE OF BUILDING <br /> <br />MAILING ADDRESS SINGLE F,~iLY B~ELLiNC~ <br /> <br />P.O. BOX 524 <br />OE1ROi1, OR 97342 <br />F'HONE: 854-3567 <br /> <br /> 15 1 10 <br />WIDTH DEPTH AREA UNITS <br />50 100 5008 . SF <br /> <br /> SITE NUNaER: 92-01183 <br /> VALUATION .* $9,076.64 <br /> <br /> 5E Rf5 <br />IRREG LOT CORNER <br /> NO NO <br /> <br />BUiLDiNG <br /> <br />OONTRACiOR, NO. <br />HILLS, GERALO <br />P.O. BOX 524 <br />DEtROit, OR 97342 <br />~ONE: 854-3557 <br /> <br />PERr4IF OR APPLiCAFION NO: 9038888 <br /> AROHI1EC1/ENGiNEER, NO. <br /> <br /> t'fP2~l <br />BUILDING FEE <br />PLAN R~¥1~ <br />BUiLOING SIA~E SURCHARGE <br /> <br />TO'FAL ~ED FEES <br />PREVIOUS RECEI P1S <br />THIS RECEIPT <br /> <br />F-JU~TI1Y <br /> <br />$80+50 <br />$52.33 <br />$4.o3 <br /> <br />$135.86 <br /> $o.oo <br />$136.86 <br /> <br />BALANCE ~JE $0.00 <br /> <br /> PAYEE: HILLS, GERALD ..4J/ 40891 <br /> R~CEIVED BY: PB ¢~, lYrE: iN CHECK ~: 0 <br /> <br /> * fH~S iS NOT A PER~iT. FBi8 APPLiCAIlOf4 NtJSF ~ THR~ A REVIEW P~E~ ~ERE IHE <br />FOLL~ING ~Sf' BE ~PLE'FEO. ir I~ THE R~BILI'TY OF THE APPLlC~[ FO ~RB FHAF <br />ALL NECE~A~ iNFO~T~ H~ BE~ P~ViOED. <br /> <br /> OIlY JURiSDiCflON: BY <br /> <br />SEPflC: BY DArE <br /> <br />ZONING: BY DATE SETBACKS: F'R 20 LS 5 R~ 5 RR 5 SP <br />RE~ARKS: CA~PORT'&'UrlLiTY'-ROOR <br /> <br />DATE <br /> <br />OFFICE COPY <br /> <br /> <br />