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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 /> DATE: 07/2t/92 'TIME: 13:02:37 <br />ow. Eh: CuMHINGS TRANSFER T~FO~Z:O <br /> <br /> ~UHSVZLLE OR 97325 ~: ;'~; OCCUPANT LOAD: <br /> <br />uSso~u~tO~RUCTURES OTHER TH~N BUILDINGS <br /> <br />PO BOX 826 <br />ALBANY OR 9732;L <br />PHONE: 929-3385 <br /> <br />;SUgDIV~VILLE AOOITION <br /> <br /> SITE'NUMBER~ '92~02671 <br /> VALUATION: $10,000.00 <br /> <br />TYPE: BUILDING PERMIT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. 40422 <br /> Oouble R Produo'ts <br />901NW E St <br />Grar~a Pass 97526 <br />PBONE: 476--1567 <br /> <br /> ITEM <br />BUILDING FEE <br />PLAN REVIEW <br />BUILOINB STATE SURCHARGE <br /> <br /> 9041597 <br />ARCHITECT/ENGINEER, NO. <br /> <br />PHONE: <br /> <br />TOTAL ASBESSEO FEES <br />PREVIOUS RECEIPTS <br />THiS RECEIPT <br /> <br />QUANTITY AHOUNT <br /> $80.50 <br /> $52.33 <br /> $4.O3 <br /> <br />$156.86 <br /> $0.00 <br />$136.86 <br /> <br />BALANCE DUE $0.00 <br /> <br /> PAYEE: CUM~INGS TRANSFER CO ~ 43448 <br /> RECEIVEO 8Y; PB ............ ] ..........~ ............ TYPE: IN CHECK ~: 0 <br /> <br /> * THIS IS NOT A PERMIT. THIS APPLICATION MUST GO THR0UGH A REVIEW PROCESS WHERE THE <br />FOLLOWING MUST BE COMPLETED. If IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT <br />LL NECESSARY INFORMATION HAS BEEN PROVIDED. <br /> <br />PLAN BEVIEW: BY ~e_~ GATE <br />ZONING: BY ............ DATE <br /> <br />CiTY ,]WRISDICTION: BY ........ DATE <br />REHARKS; CANOPY OVER GAS PUHPS <br /> <br />HEIGHT: 18 SETBACKS: FR....O <br />TOTAL SQFT: 400 l..S 0 <br />STORIES: RS-'"O <br />PLAN.ACTION: RRi]iO <br />ENERGY PATH: SP ....... <br /> <br /> OFFICE COPY <br />FORM # MC 15-56 REV. <br /> <br /> <br />