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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STRF=ET 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 em pedorming work on a property I own o occuDy <br />I am a registered builder OR ( ) he au hot zed representative ~IGNATLJR~ OF APPLICANT~ <br />Of a registered builder, <br />The work will be 13erformed by a registered builder, <br />Other <br />I have read and agree to the terms stated on the reverse side of DATE: <br /> <br />7757 BARBARA LANE SE :CtTY: j UGB: <br /> <br /> SANE <br /> F'HONE: 769-5678 <br />· ~; .................. il ~b~ .......... ~ ~' ....... f~h,~..x--- <br />~ ................... b~'~7 .............. ~ ......... ~ -- <br /> <br />TYPE: BUILDIM6 <br /> <br />CONTRACTOR. N0. <br />NCMANUS, TOM <br />GAME <br /> <br />PHONE: 769-5678 <br /> <br />PERMIT OR APPLICATION NO: <br /> <br />VALUATION: $908.88 <br /> <br /> 51423 <br />ARCHITECT/ENGINEER. NO,, <br /> <br />P40~E: <br /> <br /> ITEM <br />BUll. DING ERE <br />PLAN REVIEW <br />BUILDING STATE SURCHAEG~ <br />ZONING SURCHARGE <br /> <br /> PAYEE: MCMA~US. <br /> RECEIVED BY. MB <br /> <br /> * THIS IS A VALID <br />CONSTRUCTION CEASES FOR~ <br />EGU~RENEHTS OF STATE <br />ALL 9ECOME NULL AMD <br /> <br />ENERGY PATH: <br /> <br /> OUAN'I'ITY AMOUNT <br /> <br /> $10.48 <br /> $0.80 <br /> $8.88 <br /> <br /> $28.08 <br /> $8.00 <br /> $~8,.08 <br /> <br /> $0,,00 <br /> <br /> 53852 <br /> TYPE: CK CNECK 8: 4431 <br /> <br />FROM ITS ISSUE DATE. IF <br /> FAILS TO MEET ALL <br /> ORDINANCES, THI~ PERHIT <br /> <br /> SETBACKS: FR <br /> 0 ~ I,.S ............... <br /> RS ........... <br /> RR ........... <br /> <br />REMARKS.. DECK ~: ...... <br /> <br />DONALD E. WOODLEY~ <br /> <br />OFFICE COPY <br /> <br /> <br />