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I am performing work on a property f own or occupy, <br />I am a registered builder OR ( the authorized representative <br />of a registered bgRder, <br />The work will be gerformed by e registered builder. <br />Other , <br />I have read and acted to the terms stated on the reverse side of <br /> <br /> DATE: 09/04/<22 <br /> <br />SITUS ADDRESS; <br /> <br /> 220 H~GH ~?REET NE .... <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />~ESIOENTIAL <br /> <br /> 7591 BISHOP RD <br />AUMS¥.ILLE OR 97~;2~ <br /> <br />SINGLE FAMILY DWELLINGS <br /> <br />R-~ <br /> <br /> i NO"DER= 92-0 0Z9 <br /> <br /> MAP. <br /> <br />;WIDTH: lOE~H'. AR~A; U NmTS'. i~Ee. <br /> NO <br /> <br /> TYPE: BUILDIN~ PERMIT OR APPLICATION NO: 9042581 <br /> <br /> CONTRACTOR, NO. 58878 ~ ~ ARCHITECT/ENGINEER, NO. <br /> Kelly Ounnagan ~ : <br /> <br /> 5efferson, 97552-0000 ~ <br /> PHONE: ~27-1~8~ r~/ -, ~HONE: <br /> <br /> ITEM ~"x~?'%~.'~~%'' --~ QUANTITY AMOUNT <br /> BUILDING FEE ~~7~ <br /> PLAN REVIEW '~ _~ ~ <br /> BUILDING STATE ~UECHARBE ~ ~-~ 0~ $17.15 <br /> ZONINQ SURCHARGE ~ ~ ~ ~ <br /> <br /> ~ 8ALANCE.OUE <br /> PAYEE= Kelly Dunnagan 44445 <br /> RECEIVED BY: PW ............................. TYPE: CE CHECK ~: <br /> <br />* THIS IS NOT A PERMIT. THI3 APPLICATION NUST GO THOUGH A REVlE~ PROCESS WHERE THE <br />FOLLOWIHG HUST BE COHPLETEO. IT [STHE RESPONSIBILITY OF THE ~PPLICRNT TO ~SSURE <br /> LL NECESSARY [HFORHRTIOH HRS BEEN PROVIDED. <br /> <br />PLAN REVIEW: BY DATE HEIGHT: 21 <br />ZONING: BY ~ ...... ?~-- DATE~.~?~_~2~_~ TOTAL SQ FT: 2078 <br /> PLAN.ACTION: <br />CITY JURI$OICTION: 8Y ........ DATE__. ENERGY PATN= ~ <br /> <br />REMARK$= REBUILO OH EXISTING FOUNDATION ~ RESIOENCE <br /> <br />SETBACKS: FR~-O <br /> RsS S <br /> RR.~. <br /> sP_SSi <br /> <br />OFFICE COPY <br /> <br /> <br />