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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:588-5'147 8:00- 4:30 <br /> 24 HOUR CODE-A-PHONE: 588-7904 <br /> 8m performing work on a property, own or occupy, ~ ~-~¢~ ~.~ <br />I am a registered builder OR ) the authorized representative SIGNATURE OF APPLICANT: /~. <br />of a registered builder, <br />The work will be pedormed by ~, registered builder, <br />Other, <br /> <br />iOWNE~: DAIE; 1.2/28/92 T,:r~HE: · 9:5.8:21 ........... Y~-;4k"£5'n .......................... <br /> STOVER, LOREN ' RESiDENTIaL <br /> <br /> ZZEZ9 ~RNDT RD NE CONTR~OTCTY , U~e: ,OOOUPANTLOA~; <br /> ~URORR OR 97002 [H~RION COUNTY[ NO <br /> <br /> SINGLE F~HILY D~ELL, INGS ' <br /> <br /> ; .................................. <br /> r S[TE NUHBER: ~2-045~8 <br /> PHONE: 678-2326 ; V~LU~T[0N: $~9,2~0-00 <br /> <br /> LO+'. BLOCKr i SGCTION; ~ TOWNSHIP; ~ RANGE'. ; ZONe: MAP: <br /> <br />TYPE: BUILDING <br /> <br />CONTRACTOR, NO. <br />STOVER LOREN <br /> <br />PERNIT OR APPLICATION NO: <br /> <br /> 9044588 <br />ARCHITECT/ENGINEER, <br /> <br />NO, <br /> <br />PHONE: 67B~2526 Pi~ONE: <br /> <br /> iTEM QUANTITY AMOUNT <br />BUILDING FEE $],40.50 <br />PLAN REVIEW <br />BUILDING STATE SURCHARGE $7_05 <br />ZONING SURCNAR~E <br /> <br />TOTAL ASSESSEE FEES $245,89 <br />PREVIOOS RECEIPTS $0.00 <br />[NIS [RECEIPT $245_89 <br /> <br />BALANCE DUE $0.00 <br /> <br />PAYEE: STOVER. ORFN 46742 <br /> <br /> RECEIVED BY: PH ....................................... TYPE: CK CHECK ~', 45~6 <br /> <br />* THIS IS NOT A PERNIT. ~HIS APPLICATION, NUS~ GO THROUGH A REVIEN PROCESS WHERE THE <br />FOLLOWING NUST BE CONPLETED~ IT'IS THE RESPONSIBIL[TY:OF THE APPLICAN~ TO ASSURE THAT <br />LL NECESSARY [NFORNATION NAS BEEN PROVIOEO. <br /> <br />HEIGHT: SETBACKS: <br />TOTAL so ='"- 428 <br />STORIES: 2 RS <br />PLAN.ACTION: <br />ENERGY PATH: J. SP ........ <br /> <br />REHARKS: KITCNEN ADD,ENCLOSE STAIRS TO E×ISTING UPPER STORY <br /> <br /> OFFICE COPY <br />FORM # MC 15.~6 REV', 4/90 <br /> <br /> <br />