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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 ~ODE-A-PHONE: 588-7904 ~ ././..~- . <br /> Of a registered builder. ; j~/'-- ~ .... J""-[- .... f <br />TheotherWork will be performed by a registered builder.: %~,~ /~ ~ ~- / <br />I h~ve read and agree tO the terms stated on the reverse s~de et DATE; (!~ ~'_~- <br /> <br /> SITE NUH~ER: 94-~JB47 <br /> PHONE.- VALUAT]:OH: $36,¢ 000.00 <br />~LOT' ' ¢13L(~; ............ T 8~ ~'~8'~1~ ........ i ....... ' T~[Ri'[:~ ........... ~' ~1~7' ' 'ZONE. ' ........ I'M'%-¢ ....... <br /> <br />W DTH; DEPTH; ~ ~ ~ LJNIT$:~s tRR..E~ LOT; <br /> ' ~ <br />; ...................... ~ .................................. =-7: ......... A~ .................. ~ ................... NO ............................. <br /> <br />TYPE: BUTLD~NG PERHIT DR ApPLICATIOH <br />CONTRACTO~ NO. 61474 ~ ~.// <br /> Larry. P Koerd. g <br />5496 72nd Ave SE <br /> <br />PHONE: 585,,-8884 <br /> <br />BUILDING FEE <br />PLAN RE~IE'W <br />BUILDIHG STATE SURCNARGE <br />ZONING SURCHARGE <br /> <br />PAYIEE". LA;~;~Ry P,,KOEiq:[G~ IHC. <br />RE.r;EYVE]D BY: NB <br /> <br /> THIS IS NOT A PERHIT. THIS <br /> <br />ARCHITECT/ENGIHEER, NO. <br /> <br />PHONE: <br /> <br />QUANTITY AHOUH'T <br /> $220,,08 <br /> $14S,,00 <br /> $1t.00 <br /> <br />ESSED FEES $~85.0B <br />.'IPT $J85.00 <br /> <br />$0.00 <br /> <br />TYPE: CK CHECK ~,: 1840 <br /> <br />THROUGH A REVIEW PROCESS WHERE THE <br /> <br />FOLLOWING HUST BE COHPLETED. <br /> LL NECESSARY IHFORHATIOIJ HAS BEEN PROVIDED. <br /> ~ ~ ~ HE,IGHT: <br /> <br /> - /~ i ........ STO ~IES: <br /> · ¢ I PLAN. ACTION: <br /> CIrY Jt. JRI,;>DICT'[ON, BY ............. ~ gATE ........... ENERGY PATH: <br /> ~EHARKS: AI>I)N TO RESIDENCE (HQ BEDROOMS)¢ <br /> <br />THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT <br /> <br />800 :,l:.l BA[ .',,S, L!!~"~-'~' <br /> R S., :z.;; · <br /> R R "-~'- g .... <br /> <br />roau,~ MC ~S-~ r~s'v..e~ OFFICE COPY <br /> <br /> <br />