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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-?904 <br />( )[i am a r egist ~il~er ~)~¢~) rtthYe authoriz ed rep~esentatlveom performl on a/'~/rty I own or occupy. SIGNATUIRE OF APPL CANT. <br />("¢~) of a reg~stor Ider,¢ <br /> OtherThe work wil~.,,~e, ldrfeo, p rforme~y regl.,tered udder,, ,~/~_ <br />~ I have reaC/~n~f'ag'ree t¢ f~Fe terms stated on the reverse sido of DATE - <br /> <br /> DARE: 0472'2/92 TIME: 15:57:30 <br /> <br /> OWNER: <br /> <br /> GREEN, .JOE <br />' St'Us AObR~SS( <br /> <br /> ? 055 '19'1 <br /> <br /> 5-N <br />CONTRACT CIT'~ JGE <br /> <br />,"A~.R I ON COUNTY r~,- <br /> <br /> '11693 THRUSH COUR'I <br />AURORA OR 9?002 <br /> <br />USE OF BUILDING: <br /> <br />CATEGOR' <br /> <br /> RES1 DEN f <br />}CCUPANCY <br /> <br />}CCUPANT LOA£ <br /> <br />MAILING ADDRESS; RE~i DEN't:iAL ACCESSORY 5 11,~lJC; f UNI~'~ GUIDE[VISION. <br /> <br />20 WALK~NG NC'OD BR <br />LAKE OWBEGO, OR 9?035 <br />PHONE: 636-79t8 <br /> <br />LOT' BLOCK: SECTION; TOWNSHIP: <br /> <br />WflDTB: DEPTH: ' AREA: UNITS <br /> 59 100 5900. <br /> <br />CEN'f'RURY IVlF-ALX~.~W..'-5 NO~ <br /> <br /> ~I'I'E NUMBER: 92-01582 <br /> VALUA ! 1ON: ~;:g, &CIO .... <br /> <br />RREG LOT. CORNER <br />N(.) <br /> <br />TYPE: BUiLDiNG PERNiJ' OR APPLiCATiON NO: <br /> <br />CON'fRACf'OR, NO. 739?? <br />LAr4AIN CON$'¥'RUCTiON <br /> <br />'f'ROO'i'DALE, <br />P~ONE: '760~7736 <br /> <br /> tf'EM <br />BUILDING FEE <br />PLAN REVIEW <br />BUILDING STATE SURCHARG~ <br />ZONING GURCHARGE <br /> <br />PAYEE: JOE GREEN <br />RECEIVED BY: CL <br /> <br /> 9039536 <br />ARCH~'f'EC'f/ENGiNEER, NO. <br /> <br />PHONE: <br /> <br />TO'f'AL ASSE~EO FEES <br />PREViOUB RECEIPTS <br />'f'HJS RECEIPT <br /> <br />(~LJAN'1'~IY <br /> <br />AMOUNf <br /> $38_5o <br /> $25,03 <br /> <br /> $1.93 <br /> <br />$8%39 <br /> $0.00 <br />$67_39 <br /> <br />BALANCE DUE $0-00 <br /> <br /> 41585 <br />TYPE: CK CHECK ~: 740 <br /> <br />~ THiS iS NOT A PERf4i'I'. THiS APPL~CA'IION MUST GO I'HROUGH A REVIEW PROCESS NHERE f'HE <br />POLLON~NG SLUG1' BE f-7Of'4PLE'f'EO. J'f' ~ THE RESPONSiBILiTY Off THE APPLICANT f'O .A~RE 'f'HA'f <br />.kLL N~CESSARY,~NFOR~AfJON HAS BEEN PROVIDED. I-'~:~j~ ~ ~1¢_~ <br /> <br /> CLTY JURJSD]C'I'[ON: 8Y DAlE <br /> ~EP'f'tC: BY DATE ENERGY PATH: <br /> <br /> RENARK~ ~ CARf~RT --~--~- <br /> <br />HEIGHT: ~ 'i0 TOTAL S© FT: 240 STORIES: 1 PLAN.ROI'iON: <br /> <br /> OFFICE COPY <br />FORM # MC 15.$6 R~V, 4/90 <br /> <br /> <br />