Laserfiche WebLink
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: 5S8-7904 <br /> <br />I em a registered builder OR ( ) the authorized representative SIGNATURE E')~ APPL CANT' <br />et a registered builder. ' <br />The work will be performed by a r'egistered builder, <br /> <br />!'~iTU$ A0UREss: ............................. ~ CONS'fRUiTION TYPE~ O~CU~P~'F~CV' ..... <br /> ~ , <br /> <br /> AI)MMV}ZL.J_,E OR 97S2~ ~ MARION COuN'rY <br /> <br /> SZNG[...E F'A~ILY ~WELL, iN~S <br /> <br /> 1:1.401 S'FEZNK&b]F' ~0~9 SE ~ ~ ; ' <br />' AUH,,SVILLE 975~!,5 ~. ~ ~ ~, ~ ~ ~ SITE NUdgER: <br /> <br /> 63, ~ t qO J~O <br /> <br />TYPE= DWELLING PERMIT OR APPLiCATIOH ND: <br /> <br /> ITEM <br />DWELLIhlG BUILDING FEE <br />DWELLING PLUMBING <br />iO;~;ELL I big MECHANICAL <br />DWELLING ELE(;'f'RICAL <br />OWEL. i...IN6 STATE SUR('.:HARC~E <br />DWEL. L]:N6 F'LAN EEV:[EW <br />DWE(,,,L[NG ZC)F',iI~(~ SURCHAR(;E <br /> <br /> ?847474 DP <br />ARCHI"i'F-'CT/ENG]:IqEER,~ NO. <br /> <br />PSONE ." <br /> <br /> QUAN'fTrY ANOUN'f' <br /> <br /> $27~ 52 <br /> $85,, 27 <br /> $26.36 <br /> <br /> $15,,k/0 <br />.TOTAL ASSESSE~) FEES <br />F'IREV',[OUS RECEIPTS $~,, <br />THIS RECEIPT : $75¥. <br /> <br />BALANCE DUE <br /> <br />CiTY JURISD ICT tOi,[..,, <br />REMARKS <br /> <br /> F'AYEE: LONG, W:I:LL, IA,H ,,.-, , , 49747 <br /> <br />$ THIS IS NOT A PERfllT, THIS APPLICATION ~UST GO ~HROUEH A RE~E~ PROCESS ~HE~E THE <br />FOLLOWING MUST BE COMPLETE~. IT I8 THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT <br /> LL NECESSARY ~MFQE~ATION HAS BEEN <br /> <br /> HEIGHT: 15 SE'I'~A~;KS~: F'R..~.~ <br /> TOTAL <br /> <br /> PLAN. ASTION: RR~ <br /> ENERGY PA'I'H ~ <br /> BY DATE : <br /> <br />FOnM# MC 1~-56 Rb~/. 4/~O OFFICE COPY <br /> <br /> <br />