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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 grogerty I own or occupy. <br />t am ~ registered builder OR the authorized rep~esentatlve <br />of ~ registered builder, <br />The work will be performed by a registered builder. <br />Other_ <br /> <br />I have read and 8gree to the terms stated on the reverse side of <br />this document. <br /> <br />' OWNER; TAX LOT: CATEGORY: <br /> ORR, LARRY 5'~"!06-090 RES i DEN'"' 1.~ <br /> SITUS ADOR~i CONSTRUCTION TYPE; , OCCUPANCY: <br /> <br /> 330 b~ERGREEN OR 38~'5~8~Ei~,. ;'0OOUPANT LOAD: <br /> AU~ViLLE OR 97~25 <br /> <br />USE OF BUILDING; NO OF BEDROOMS: <br /> <br />:MAII. tN~i ADDreSS': R~i-OEN:f' iAI:- Af, g~E$~I~Y STRtJrD:i"URE~ S~6~i~i6~i ......... <br /> <br />i PHONE~ SiTE NUNSER: 92-01534 <br /> VALUATION= $3,120.00 <br /> <br />, 8 , : 8S! 2N ~M <br /> 55 85! 4675. SF NO; NO <br /> <br />TYPE: BUILDING <br /> <br />CONTRACTOR, NO. <br />ORR, LARRY <br /> <br />PERM~'F OR APPLiCATiON NO: <br /> <br /> 9039444 <br />ARCHITECT/ENGINEER, NO. <br /> <br />PHONE; <br /> <br /> iTEM <br />BUILOiNG FBE <br />PLAN REVIEW <br />BUILDING STATE SURCHARGE <br /> <br />TOTAL ~F-&~SED FEES <br />PREViCUS RECEIPTS <br />THIS RECEIPT <br /> <br />OUAN'T'iI'Y AMOUNF <br /> $44.50 <br /> $28.93 <br /> $2.23 <br /> <br />$Y5.55 <br /> $0.00 <br />$75. ~(~ <br /> <br />BALANCE DUE $0.00 <br /> <br />PAYEE: CRAIG LUCA~ <br />RECEIVED BY: PB <br /> <br /> 41488 <br />rYPE: IN CHECK ~: 0 <br /> <br />:¢ THiS ~;S NOT A PERf4i'T'. THiS APPLiCA'I'ION MUST GO THROUGH A REVIEW P,R'OCE~ WHERE THE <br />FOLLOWING fvitJ~'[' BE COMPLETED. IT IS THE RESPON~IBiLi'F'Y OF THE APPLICANT TO A,SSURE 1HAF <br />ALL NECE~ARY INFORIMATION HA~ BEEN PROVIDED. <br /> <br /> ....... <br /> CiTY JURiSDICTiON: BY DATE <br /> SEPTIC: BY DATE ENERGY PATH: <br /> ZONING.~ BY OAI'E ~E'IBACKS: P'R 10 LS 10 RS 10 RR 10 SP <br /> REMARK8: CARPORT ............................................................... <br /> <br />~ HE~GH'J: 11 TOTAL 5Q F'r: 312 SFORIES: 1 PLAN.ACTiON: <br /> <br />OFFICECOPY <br /> <br /> <br />