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MARION COUNTY BUILDING INSPECTION <br /> SENATOR BLDG. NO. 225 <br /> 220 HIGH STREET NE <br /> SALEM, OREGON 97'301 <br /> <br /> PHONE: 588-5147 8:00- 4;30 <br />t 24H OUR CODE-A-PH ONE t E88-7904 //.~ <br /> ) I am gerfornSng work on a property I own or occupy, <br /> I am ~ registered builder OR ( ) the authorized rep esen ave SIGNATURE OF APPLICANT: <br /> //- / ~.,.,,- <br /> <br /> of a registered builder, <br /> ((~)) TheotherWOrk will be performed by a reois,ered builder. / ~. <br /> I hsve read and aDree to the terms stated on the reverse side of BAT <br /> this document, <br /> <br />,owN'~'f'E: 04/22/g2 TIME: 16:16:06 <br /> <br /> GREEN, JOE <br /> SITUS ADDRESS: <br /> <br />TA) LOT' CATEGORY: <br />CONSTRUCT ON TYPE: OCCUPANO~ <br /> <br />RESi DENY IAL. <br /> <br />11684 LARK COURT -- <br />AURORA OR 9'7002 <br />USE OF 8Ul~lr~m. MARION ur, JUN !-' NIJ 'N0 OF BEDROOMS <br /> <br /> 20 WALKING WOOD DR <br /> LAKE OSWEGO, OR <br /> PHON~: 636-7919 <br /> <br />WIDTH: 2~ DE~H' ~ 9 A~EA. 3~ <br /> 65 85'~ ......... 5.525. <br /> <br />g;gNTURY ~EA£~ NU 4 <br /> <br /> V~ _UA i~: <br /> <br />~[~S: 3~ RREG. LOT 'l~ ~ORNER: <br /> ~ . NC NU <br /> <br />'[YPE: PLU~4B iNG <br /> <br />PE~I'T' OR APPLiCATiON NO: <br /> <br />CONTFO~kC"['OR, NO. <br /> LAMAIN CONSTRUCTION <br />206 SE 4TH <br />'r'ROu'rOALE, 97050~0000 <br />PHON~: '760~?'736 <br /> <br /> i'f'F_J'4 <br />WA]ER LINES, 1S'T 100 FEET <br /> <br />PLUMBING 5'IAYE E;dRCHA~E <br /> <br />9039641 <br /> <br />TO'TAg ~EO FEES <br />PRE¥IOUS RECEIPTS <br />THiS RECEIPT <br /> <br />BALANCE OUE <br /> <br />QUAN'/'it'Y <br /> I $20.00 <br /> <br /> $2.50 <br /> <br />$52.50 <br /> $0,00 <br />$52_5O <br /> <br />$0.00 <br /> <br /> PAYEE*-GREEN, JOE RECEIPT NO; 4,1590 <br /> RECEIVED ~Y: CL, ........................................................................................................... 'TYPE: CF, CHECK ~: 4.1586 <br /> <br />~" THIS I$ NOT A PERMIT. THiS APPLICATION MUST GO THROUGH A REVIEW PROCE~ ~ERE THE <br />FOLLOWING f, IUST BE COfflPLETEO. IT IS THE RESPONSIBILITY CE THE APPLICANT TO ~RE THAT <br />ALL NECE..-'~ARY INFOR/'4ATION H.~.S BEEN PROVIOED. <br /> <br />PLAN REVIEW: BY <br />RE~ARKS~ ~t., ~L <br /> <br />OA'I'E ................................................. <br /> <br />CI'fY JURiSO[C'fI~: 8Y DA'f~ <br /> <br />OFFICE COPY <br /> <br /> <br />