|
MARION COUNTY BUILDING INSPECTION
<br />SENATOR BLDG. NO. 2,25
<br />220 HIGH STREET NE
<br /> SALEM, OREGON 97301
<br />
<br /> PHONE:588-514? 8:00- 4:30
<br />24 HOUR CODE-A-PHONE: 588-7904
<br />
<br /> of a registered builder,
<br /> The work wNI be Cerformed by a registered builder.
<br /> Other
<br />
<br /> , H ~ ,~ .... ~A~'~'; :[ ~- ~+ ............ ' ...... ' ....
<br />
<br />ADDRESS: ' ........................................(' ,
<br />
<br /> OR 97342 .~i~-'~'~T:~'. ........ j~
<br />
<br /> PHONE: 286-"69',];-.-.8966 VALUATIOiq:
<br />
<br />IWIDTH ~ DEI~'T'H. ' ~"~ AR~'A: .... ~;~12~ - UNITS!" ~!:; ...........IRFfE'G,I"~¢]' ............ LOT
<br />
<br /> I TI:_:'. M
<br />I)I/ELLINf; N,JZ[LD:[Nf; FEE
<br />D1,]ELI... t MG ;:'LUMB];NG
<br />.~)~EL L.. NqC MECHANICAL
<br />I)WEI_.L :qt(;. ELECTRICAL
<br />DWELL:INK STATE SURCHAFd_i.F.
<br />DWEL, L;i:N(;. F'L.A!,I REV]:EW
<br />
<br />ARCI i.[ f EC~/Lr~u,.N',ILL.,, r,T N(].i
<br />
<br />PHONE:
<br />
<br />QOANT I TY
<br />
<br />A i'I fl)Ul',l T
<br /> $29r,/h,
<br /> $1~t6,,
<br /> $26,,43
<br /> $82 ,, {:IS
<br /> $25,,51
<br />
<br /> PAYEE;; JEI:;';:'REY,, CI-IAgE-,~,,. ,/'-',
<br /> ~EC~~ 'vid BY tlt ~1\1\ V,.-.-4. .............
<br /> ..... - ............ TT-. J i',] p~ :~ ~
<br /> ............................................ :[:.: :.,':;;~ ............................................ - ...............
<br />
<br />FOLLOWING MUST BE COMPLETEJD~ Ill I8 THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT
<br />
<br />LL NECESSARY tNFORMA~TIJ%N,HAS BEEN PROVIZ)El),
<br />PLAN REVZ,?.W, 1[/"¢ ~'~'"~--~ DA'r: --~X ~ %~
<br />.,., ..... ,, , ............
<br /> Z/L.LI.H=. ~ ..... _,. ~ · .
<br /> ~" ::" '" '~' ~ Y ........ ¢~ ...................... D~'T "-"' ";; ............................
<br />........ .................... ...........
<br />
<br /> H ,: I. G H 'f ,, 23 S E 'f' Ii: A C i'~ S: F R, 2 ¢
<br /> 'f'OTC~L S(:,l F'T:i /.!;:48 (..5
<br />
<br /> PLAN. AC T)i ON: RR :L 5
<br />...... , ,.. c Iql;,I.,G Y I:;'A'¥ f.i :;
<br />,.' ....... f f f ,..I U R :ii S l) ]1 C "[' I ti} N: *:, Y }] A 'f' iii:
<br />kk?lAR,'-;!,h¢ iD. ,J...Li , ,~ A!'i),)'"S.F,,EP~!:;E Tl·d::.l :.,FI ,;~ ;*STE· ~
<br />
<br /> /~-~~ , ' _.....~ .......
<br />
<br /> OFFICE CO~Y
<br />
<br />
<br />
|