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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:(~2 - 4:30 <br /> 24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am performing work on a Property I own or occupy. <br />I am e registered builder OR the 8uthorlzed representative SIGNATURE 0¢ APPLICANT: <br /> of a registered builder, <br />The work wil} be performed by a reg}$tered builder. <br />Other <br />I have read and ~gree to the terms stated on the reverse side of DATE; <br />this document, <br /> <br /> 12264 SILVER FALLS HWY .... I'b%'~i~;~¥CiYf; ....... [-'u"~'~i <br /> <br />~AHE ', ~I:fi%PROCESS IN~i PLAN'[ ; <br /> ' SITE NUMBER~ <br />PHONE: 769.-21~ i VALUATION: <br /> <br /> ~ ~ ; ,-...~]., ~ t---:::~,~¢~ . ,,..; <br /> <br />TYPE: BUILDING PERMIT OR APPLICATION <br /> <br /> ITEH <br /> <br />PL_AN RE¥~E~ <br />BU];L~IN~ STATE SURCFIARGE <br /> <br /> 4§8?4 <br /> <br />ARCHI TEC'f/ENf; I NEER., NOu <br /> <br />F'HONE= <br /> <br />TOTALASSESSED FEES <br />PREVIOUSRE'CE~PI'S <br />:THIS RECEIPT <br /> <br />QUAN'¥' :1: 'fY <br /> <br />AHOIJNT <br /> <br />$136~86 <br /> $0.00 <br />$136.86 <br /> <br /> P~YEE: Joseph F Unger : 48100 <br /> RECEIVED BY: ~B TYPE' CK r"-ECK <br /> "' ' ............. , ............................................. ~ ....................... ~ <br /> <br /> * THIS IS A VALID PER~IT. THIS PERMIT:EXPIB:ES 188 DAYS FROM ITS ISSUE <br />CONSTRUCTION CEASES FOR A PERIOD' OF 18~ DAYS, OR IF CONSTRUCTION FALLS TO MEET ALL <br /> EOUIREMENTS OF STATE LAW~ AND MARION OoUNTy BUILDING AND ZONING ORDINANCE~ THIS PERMIT <br /> ALL BECOME NULL AND VOID. <br /> <br />ENERGY PATH: <br /> <br />REMARk,. RAMF' EOR HAND'ICAP <br /> <br />HEIGFIT: <br /> <br />STORIES: <br />PLAN, AL'T~OH~ <br />ENERGY PATH: <br /> <br />SE-fBAEK8: r:'R <br /> L.S ........... <br /> <br /> RR <br /> <br />I')[INALD E.. I¢~CIOI)I...F:y, fd,¢d~C.I;ON COUNTY BUILI)IN(]; OF:FILIAL / BY .............................................................................................. <br /> <br /> <br />