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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 a registered builder OFf ( ) the authorized representative <br /> <br />I OWNER: TA~ ~: CATEGORYZ <br /> HOZZILLO, 6REG 57706-000 RESiDENTiAL <br /> <br /> 5~N ~ <br /> 280 EVERGREEN OR 8 6'~¥~X~'ifSi ,OCCUPANT LOADr <br /> AUHSVZLLE OR 97S25 AUMSVILLE I NO : <br /> <br />USE OF DUI[DING: <br /> RESIDENTIAL ACCESSORY STRUCTURES <br />MAILING ADb"Ess: <br /> <br /> ~ SITE NUMBER: 92-05255 <br /> PHONE: ~99-78[0 ! VALUATION: $3,640.00 <br /> <br /> 55 ; 85! 4 75. I SF i NO ' NO <br /> <br />TYPE: BUILDING <br /> <br />CONTRACTOR, NO. 42256 <br /> CAPITOL AWNING <br />518 VALLEYWOOO DR SE <br />Salem, 97~06-0000 <br />PHONE: ~6S~1711 <br /> <br />PERMIT OR APPLICATION NO: 9042520 <br /> <br /> ARCHITECT/ENGINEER, NO. <br /> <br />PHONE~ <br /> <br /> ITEM QUANTITY AMOUNT <br />BUILDING FEE $44.50 <br />PLAN REVIEW $28.93 <br />BUILDING STATE SURCHARGE $2.2~ <br /> <br />TOTAL ASSESSE[ FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />$75_66 <br /> ~OlO0 <br />$75,66 <br /> <br />,BALANCE DUE $0.00 <br /> <br /> PAYEE: Santiam Homes 44587 <br /> RECEIVEO BY: PB ................................. fYPE~ IN CHECK ~: 0 <br /> <br />* THIS IS NOT A PERMIT. THIS APPLICATION MUST GO THROUGH A REVIEW PROCESS HHERE THE <br />FOLLOWING MUST BE COMPLETED. [T~ I~THE 'RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT <br />LL NECESSARY INFORMATION HAS BEEN' PROVIOEO~ <br /> <br />HEIGHT= SETBACKS: FR 10 <br />TOTAL SQ FT~ ~64 LSd/ <br />STORIES: 1 RS 6 <br />PLAN.ACTION: RR~iO <br />ENERGY PATH: SP ........... <br /> <br />PLAN REVIEW: <br />ZONING: BY <br /> CATE <br />SEPTIC: <br /> DATE]_- <br />CITY JURISOICTION: 8Y ........ OATE <br />REMARKS: CARPORT <br /> <br /> OFFICE COPY <br />FORM # MC 15-56 REV. 4/90 <br /> <br /> <br />