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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO, 225 <br />220 HIGH STREET NE <br /> SALEM1 OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br /> 24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> I am porfor~?ng work on a property I own or occupy <br /> lam 8 regirtered builderOR{ ) the authorized representative <br /> o¢ a registered builder. <br /> The work will be performed by a registered builder. <br /> Other__ <br /> I have read and agree to the terms stated on the reverse side of <br /> this document. <br /> <br /> DATE: 11/24/92 TIHE: 9:28:17 <br />OWNER: <br /> REA, ROBERT <br /> <br />THE PIZZA PEDDLER <br /> <br /> 325 HAIN ST <br />AUHSVILLE OR <br /> <br /> ~:~ C I AL <br /> 60N STR'bbTK~N ¥;d5~i OCCUPANCY: <br /> 5--N 8-2 <br /> <br />97325 ', ~ ~1'~'~ Lg~]LY i OCCUPANT LOAD; <br /> <br />STORES AND OTHER MERCANTILE BUILDINGS <br /> <br />PO BOX 109 <br />AUMSVILLE OR 97325 <br />PHONE: 749-4010 <br /> <br />SITE NUMBER: 92=04%00 <br />VALUATION: $10,000.00 <br /> <br />LOT; I~LOC K: ~E~flON: TOWNSHIP: RANGE: .... MAp: <br /> <br />TYPE: BUILDING PERMIT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. <br />REA~ ROBERT THE PIZZA PEOOL <br />PO BOX 109 <br />AUHSVILLE OR 97525 <br />PltONE: 749-4010 <br /> <br /> 9044076 <br />ARCHITECT/ENGINEER, NO. <br /> <br />PHONE: <br /> <br /> ITEM QUANTITY AMOUNT <br />BUILDING FEE $80.50 <br />PLAN REVIEW $52.$$ <br />BUILDING STATE SURCHARGE $4.03 <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />BALANCE DUE <br /> <br />$156.86 <br /> $0~00 <br />$136.86 <br /> <br />$0.00 <br /> <br /> PAYEE: REA, ROBERT THE PIZZA PEDJ;~z~R ~46152 <br /> RECEIVED BY: PB -- TYPE: IN CHECK ~ 0 <br />................. :::::::::::::::::::::::::::::::: .............................. 2 <br />· THIS IS NOT A PER~iT. THIS APPLIOATION MUST 60 THROUBM A REVIEW PROCESS WHERE THE <br />FOLLOWING ~UST 8E COMPLEfEO. IT I$ THE REBPONSIBILI?Y OF THE APPLICANT TO ASSURE THaT <br /> <br />CITY JURISDICTION: BY ........ DATE ......... <br />REMARKS: INTERIOR REMODEL <br /> <br />HEIaHT: 16 SETBACKS: FR <br />TOTAL SQ FT: 2128 LS ........... <br />STORIES: 1 RS ....... <br />PLAN.ACTiON: RR ...... <br />ENERGY PATH: spZZZ'~ <br /> <br /> OFFICE COPY <br />FORM # MC 15-~ R~V, 4/50 <br /> <br /> <br />