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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 performin9 work on a property I own or occupy. . <br />lam a registered builder OR{ )theauthorizedrepresentatlve <br />of a registered builder. <br />ThC work wil be pe ¢~rmed by a reg $ e ed builder. <br />Other. <br /> <br />DATE; <br /> <br /> DDTE; 02/09/9~ TIME: 9:57:22 <br />OWNER. <br /> OREGON OEPT OF TRANSPORTATION <br /> <br /> 600 N SAN'¥IAH HWY <br />DETROIT <br /> <br />SERVICE STATIONS <br /> <br />OB ?7542 <br /> <br />TAX LOT' <br /> <br />CONSTRUCTION TYPE <br /> <br /> ~¢~J'f)N .DUNTY <br /> <br />UGE <br /> NO <br /> <br /> P 0 BOX 582 <br /> DETROIT OR <br /> PHONE: 854-3429 <br /> <br />LOT ,BLOCK. SSC'?ION' TOWNSHIP: <br /> 12 iO <br />WIDTH~ ;DEPTH' AREA: UNrT~: <br />O_ <br /> <br />;OMMKRC]'AL <br />B'~2 <br /> <br />SITE NUMBER: 95-00498 <br />VAL JATION: $59.048_0( <br /> <br /> 5E I IO5 <br /> <br />TYPE: BUiLDiNG PERMIT OR APPLICATION NO: <br /> <br />CONTRACTOR, <br />OREGON DEPT OF TRANSPORTATIO <br />P 0 BOX 582 <br />DETROIT,, OR <br />PBONE: 854-5429 <br /> <br /> ITEM <br />BUILDING FEE! <br />PLAN REVIEW <br />SITE PLAN REVIEW, BUILDING:iNSPECTION <br />SITE PLAN REVIEW, PUBLIC WORKS <br />BUILDING STATE SURCHARGE <br />ZONING SURCHARGE <br /> <br /> 9045214 <br />ARCBII'ECT/ENQINEER, NO. <br /> <br />PHONE: <br /> <br />TOTAl. ASSEBBEO FEE3 <br />I~REVIOUS REC=IPTS <br />THIS RECEIPT <br /> <br />QUAHTITY <br /> <br />AHODNI <br /> $238.00 <br /> $IS4.?0 <br /> $4.O0 <br /> $75.OO <br /> $:1.2_9D <br /> $11.90 <br /> <br />:I, 495. !L, D <br /> St'). O0 <br /> ,I; 0,00 <br /> <br />BALANCE DUE $495_BD <br /> <br />PAYEE: 0 <br />RECEIVED BY: CL_ ................................... I'YPE:: CHECK ~: 0 <br /> <br />· THIS IS NOT A PERMIT. THIS APPLICATION MUST 00 THROUGH A REVIEW PROCESS WHERE THE <br />FOLLOWING MUST BE COMPLETED. IT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT <br />LL NECESSARY INFORMATION NAS BEEN PROVIDEO. <br /> <br />PLAN REVIEW: BY DATE . HEIGHT: 0 SET,lACKS: F:R <br />ZONING: BY .................... OATE ............................ tOTAL sq F'(: 7~0 <br />.>EF. FIC: ElY ..............................DATE ................. STORIES: 1 <br />F'USL I 0 NOR~'?"~ ................... DAT~ ........................ PLAN.ACTION: RR <br /> <br />REMARk. S: FUEL BLOB NI'I'H CANOPY (PLANS REVIEW& SITE PLAN $2~5.00) WILL BRING IN CHECK <br /> FOR $2~.00 BAL OUE <br /> <br /> OFPICE COPY <br />FORM # MC 15-56 REV. 4/90 <br /> <br /> <br />