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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-PRONE: 588-7904
<br />
<br />The work will De pecformed by a reQistered builder.
<br />I have read and ~gree to the terms ~a~e~ on the reverse sl0e of OAT*:-~A~-~ ~.~ ~-.~ ~
<br />
<br /> Ad?~SV]:LLE OF~ ?7325 LdAR'.H)N COUNTY] NO J ,
<br />USE OF BU LO N~J ~NO: OF BEOROOMS
<br />
<br /> 37~647 GTLKEY R:O
<br /> ~L.,.[.) OR ?'?:~25 ! SITE NUMBER:
<br /> "-"; "'" ~2 ~-'T76' _ .
<br /> Ft ] {E ..... VA[ UATION',: $17,44~,,~
<br />
<br /> ~ TOWNSHIP: ~ [ I
<br />AOT= T~Ebdk ~S~Ct oA ............................... ,'-~X~ .............. ~b~r ~'~
<br />
<br />TYPE: BUILDiN~ PER~IT OR APPLICATION
<br />
<br />l",[] ,'~ T!:~' A C T i75:~ ~
<br />S'!': ev ~,)yI
<br />94!8 ENCHANTED ~,,~AY
<br />
<br />~,~ "'
<br />
<br />I~U:[L.D]'NG FEE
<br />PLAN
<br />BU]'LI)ZNG
<br />ZON]:HG SURCHAF~GF
<br />
<br /> 70519~6
<br />
<br />A R C HI T E C'F/EIqI,TI: NIr_E:R,
<br />
<br />PHONE:
<br />
<br />8UANTtTY
<br />
<br />AMOUNT
<br /> M. 4~,' ,, 5~)
<br />
<br /> $7,, 05
<br /> $7., 83
<br />
<br />TOTAL ASSESSI'_TO FEES ~ 245,,89
<br />F E,'~ ,,.0,,,,~ ELC, E,[I: T,:, m~,,
<br />THIS ~ECEIF'T ~4, ,, ~
<br />
<br />T!A~AN.E D JE ~f_t,, ~
<br />
<br /> F,,~YE,,I ...... Meven I.~,.~, ^ I/'~.. .4387
<br /> ,LCL.I, VI..'D';' ; ' :' ;~,.Y." H.sA ~]_~ . TYb~.-:" CK' L, HECA' - ' ,I,.* 3.,t4
<br /> ~ THZS IS NOT A PERMIT, THIS APPLICATION flUSI ~ THROUGH A REVIEW PROCESS WHERE THE
<br />FOLLOWING ~UST ~E COMPLETED. IT IS THE RESPONSIBILITY OF THE APPL~CAHT TO ASSURE TH4T
<br />
<br />LL NECESSARY tNFORttATION NAS BEEN PROVIDED.
<br />
<br /> SE F"l- ]:[2:: ~f~Y .................................... %¥T'E ............................
<br /> ,I. , *,~ , P(')LE'
<br />
<br /> HEII;HT.,
<br /> 'TOTAL .S£I FT: 2].60
<br /> STORIES:
<br />
<br /> ~NEF4;Y
<br />
<br />'"" X;
<br />
<br />~[ fEA(,I ,:,,,
<br />
<br />F(.;>/
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<br />FORM # MC 1S-~ REV, 4,~'~0 OFFICE COPY
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