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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- <br /> 24 HOUR CODE-A-PHONE: 588-7904 t <br /> <br />( I am performing work on a property I own or occupy, f <br />( I am a re¢gistered builder OR the authorized representative SIGNATURE OF APrLIQAN'i': <br /> of a rogbtored builder. <br />( The work will be performed by e registered builder. <br />( Other~ <br />( I ~ave read 8nd agree o he erm8 stated on the reverse side o¢ DATE~ <br /> this document. <br /> <br /> D~TE: 0.8/~0/~ <br /> OWNER: TAX LOT'. ; CATEGORY; <br /> L~KE~OOD HOMEOWNERS~ INC. 72650-006 , COHHEROZ~L. <br /> <br /> 13262 DAIQUIRI~ ~ DR ? <br /> <br /> AURORA OR 97002 , HAR~ON COUNTY NO <br /> <br /> PUBLIC ~ORKS ANO UTILITIES BUILOINCS <br /> <br /> L~KE~OOD EST. <br /> <br /> PHONE: 678-5746 V~LUATION: $1,000~00 <br /> LOT; 8bbE~i ,'~i'~'~i ' fb~H ~': <br /> <br /> 20 85 . 06' YES NO <br /> <br />TYPE: BUILDING PERHIT OR APPLICATION <br /> <br />CONTRACTOR, NO, 47663 <br /> DA NEAL CONSTRUCTION <br />3170 $N RIVERFRONT TERRACE <br />WILSONVILLE, 97070 <br />PHONE: <br /> <br />BUILDING FEE <br />PLAN REVIEW <br />BUILDING STATE SURCHARGE <br />ZONING SURCHARGE <br /> <br /> 9041824 <br />ARCHITECT/ENGINEER, NO. <br /> <br />PHONE: <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />QUANTITY <br /> <br />AHOUNT <br /> $i7.50 <br /> $11.38 <br /> $0.8B <br /> $0_88 <br /> <br />$30.64 <br /> $0,00 <br />$30.64 <br /> <br /> BALANOEDUE $o,,oo <br /> t\\ <br /> PAYEE: <br /> OANEAL <br /> CONSTRUCTION <br />============================================ .......... .... <br />· THIS IS NOT A PERMIT. THiS APPLICATION gUST GO THROUGH A REVIE~ PROCESS WHERE THE <br />FOLLOWING MUST BE COMPLETED. IT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT <br />LL NECESSARY INFORMATION MAS BEEN PROVIOEO. <br /> <br />CITY JURISDICTION: BY ........ DATE <br />REMARKS: FOOTING FOR TOWER <br /> <br />HEIGHT: 32 SETBACKS: L~_,~'__,,_ <br />TOTAL SO FT: 0 <br />STORIES: R~_'~ <br />PLAN.ACTION: RR.~ <br />ENERGY PATH: SP]ZZZ <br /> <br />¢O~M # MC 1¢-d6 REV, 4/~ OFFICE COPY <br /> <br /> <br />