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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 />i am performing work on a property I own or occupy. <br /> <br />SIGNA"URE OF APPLICANT; <br /> DATE: <br /> <br /> DATE: 02/12/9,3 'riME: B:.58:25 <br />OWNER: <br /> OREGON DEPI OF TRANSPORTATION <br />SfTUS ADDRESS: <br /> <br /> 600 N SANTIAN HWY <br /> DETROIT <br /> <br />USE OP BUILDING; <br /> SERVICE 8TA rIONS <br /> <br />TAX LOT: <br /> <br /> CONSTRUCTION TYPE: <br /> <br /> .... ~O~R~CT CITY: UGh: <br />OR 97,542 MARION CODNTY NO <br /> <br />SUBOIVISION: <br /> <br />P 0 BOX 582 <br />DETROIT,, OR <br />PHONE: S54~.3427 <br /> <br />SITE NUNBER: <br />VALUATION: <br /> <br />CATEGORYz <br /> COMMERCIAL <br /> <br />95-00498 <br /> $59.,048.00 <br /> <br />NO OF BEBROOM$ <br /> <br />LOT: BLOCK; SECTION; TOWNSHIP'. RANGEZ ZONE; MAP: <br /> <br /> 12 10 5E 'f'C 105 <br /> NO NO <br /> <br />TYPE: BUILOING PERMIT OR APPLICATION NO: <br /> <br />CONTRACTOR. NO. <br />OREGON SEPt OF TRANSPORTATIO <br />P 0 BOX 582 <br />DETROIT, DR <br />PHONE;; 854-5429 <br /> <br /> ITEM <br />BUILDING FEE <br />PLAN REVIEW <br />SITE PLAN REVIEW, BUILDING INSPECTION <br />BITE PLAN REVIEW, PUBLIC WORKS <br />BUILDING STATE SURCHARGE <br />ZONING SURCHARGE <br /> <br /> 9045214 <br />ARCHITECT/ENGINEER, NO. <br /> <br />PHONE: <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />BALANCE DUE : <br /> <br />QURNTITY <br /> <br />AMOUNT <br /> $239.00 <br /> $154_70 <br /> $4..D0 <br /> $75_0O <br /> $11,,90 <br /> $I. 1_90 <br /> <br />$495.5O <br /> $0.00 <br />$235.0( <br /> <br />$260.50 <br /> <br /> PAYEE: OREGON DEP;~F¢]~ANSPOR'TATION 4Fare <br /> <br />* THIS IS NOT A PERHIT. THIS APPLICATION HUST GO THROUGH A REVIEW PROCESS WHERE THE <br />FOLLOWING HUST BE CBHPLETEO. IT IS THE RESPONSIBILITY OF THE ~PPLICANT TO ASSURE THaT <br />LL NECESSRRY INFORH~TION H~S BEEN PROVIDED~ <br /> <br /> PLAN <br /> ,, ~ ZONING: 8Y~ '~ ........... OATEn-,~ Y~"" TOTAL SQ FT: <br />,~ .~EPTIC: B~'~ ............ D~TE_~]~Z~'~]]] STORIES: 1 <br /> PUBLIC ~01~'~-~-'-8~7 ............ O~lE -- ~ PLaNt'Gl'ION: <br /> <br /> REMARKS: F'UEL BI_DG WI'FN CANOPY (PLANS REVIEW& SITE PLAN <br /> <br />OFFICE COPY <br /> <br /> <br />