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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 />of ~ registered builder, <br />The work will be performed by a registered builder, <br /> <br />this document, <br /> <br /> Y~S, T~ ~ RE~iD~I'IAL <br /> <br /> ~, 5.~ ~ M-1 <br /> 11115 J~ NAY ~E ) CONTRACT CITY; j UGB; ~OCCUPANT LOAD; <br /> <br />P.O. BOX 632 <br />STAYT~, OR g?~82 ~ <br />~E:' 769-7544 ' I I SITE NU~ER: 92--02081 <br /> <br />TYPE: BUiLDiNG <br /> <br />OONTRAOI'OR, NO. <br />YOUIVta, NS, 'rot,1 <br />P.O. BOX 632 <br />S'FAYTON, OR g738~ <br />PHONE: 769-7544 <br /> <br />PEI~IiT OR APPLICATION NO: <br /> <br /> iTE]~ <br />BUILDING FEE <br />PLAN REVIEW <br />BUILDING STATE ~JRCHAR6E <br />ZONING ~SURCHARGE <br /> <br /> 9040319 <br />ARCHiI'ECT/ENGiNEER, NO. <br /> <br />PHONE*. <br /> <br />QUANTITY <br /> <br />TOTAL AE~BE88ED FEELS <br />PREWIOUSREOEIPTS <br /> RECEIPT <br /> <br />~92.50 <br />60.13 <br /> <br /> 4.63 <br /> <br />$161.89 <br />$77.89 <br />$o.oo <br /> <br /> PAYEE: ~'7 <br />--- RECEIVED BY:~ __ ~ PB_ ~-: ..................... 4/~ ............... TYPE: CHECK ~: 0 <br /> ~ THiS l~ NOT A PEh~iT. THiS APPLICATION fflusl GO,THROUGH A REVi~ PR~ ~ERE THE <br /> ~iNG '~ST BE ~PLE'rED. IT I8 ~HE ~iBtLITY OF THE APPLi~T TO A~RE l'~'f' <br /> ALL N~RY INFO~II~ H~ ~E~ P~IDED. <br /> <br />PLAN REVIEW: BY DATE <br /> CiTY JURISDICTION: BY DATE <br />SEPT[C= ~Y DATE ~lEk-"G~ PATH: <br /> <br />ZONING= BY BATE SETBACKS= FR 20 LS 5 R~ 5 ~R 5 SP <br />R~RK~: ~TO~E'"'8[OG (PORE) ..... APPROVED ?OR'PRIVATE-NONCOt~4ERCI~E'"'0SE <br /> <br />HEIGHT= 10 TOTAL 8Q FI'~ ,. 1440, STORiE~: 1 PLa~.ACTiON: <br /> <br /> OFFICE COPY <br />FORM # MC 16-§6 REV, <br /> <br /> <br />