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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 />of a registered builder, <br /> <br />S{GNATURE OF APPLICAN~ <br /> <br /> 1704100?0 <br /> I RI='SIDEN]YAL <br />ADDRESS; ~ CONSTRUCTION TYP~; i OCCUPANCY; <br /> I1~04 J~MES WAY DR SE <br /> <br /> OTHER NON-RESIDENTIAl.. BUILDINGS <br /> <br />  SITE HUMBER: <br /> PHONE: VALUATIOH: $1~, <br /> <br />TYPE: BUILDING PERHiT OR APPLICATION NO: 9B53290 <br /> <br />CONTRACTOR~ NO. 75100 t <br />L & M Construc~io~q It4c \\ <br />~38 46~h P]. SE ,..-~r,~\,l <br />Salem, 973~1-0800 ~y <br />PHONE: 581-8530 ~ <br /> <br />ARCHITECT/ENGINEER, NO. <br />PHONE: <br /> <br /> ITEM <br />BUILDING FEE <br />PLAN REVIEW <br />BUILDING STATE SURCHARGE <br />ZONING SURCHARGE <br /> <br />QUANTITY <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS, RECEIPT <br /> <br />AMOUNT <br /> $98,.50 <br /> $64.0S <br /> <br /> $4.9S <br /> <br />$17~-. 39 <br /> $0,, 00 <br />$172.39 <br /> <br /> BALANCE DUE $0,,08 <br /> <br /> PAYEE: L & M Con~tr~ction Inc 5575~ <br /> RECEIVED BY: CL_ .................................... TYPE: CK CHECK :~: 6428 <br /> <br />* THIS IS HOT A PEI~NIT. THIS APP~ICATION',NUST ~.THROU~H A REVIEW PROCESS WHERE THE <br />FOLLOgING HUST ~E COHPLETED./~IT/IS,THE RESPOI~I~ILITY OF THE APPLICANT TO ~SSURE THAT <br /> LL NECESSARY IHFOR~ATION HAS BEEN PROVIDED. <br /> <br />PLAN REVIEW: BY ~ DATE HEIGHT: <br />Z~NING: ~,__.~__~.~ ...... .:: DATE TOTAL SQFT: <br />SEPTIC: ~¥ .... :==="===':=__ DATE::::'~::=~::: STDRIE~: <br /> PLAN~ACTiON: <br />CITY JURISDICTION: BY ........ DATE ................ ENERGY PATH: <br /> <br />REMARKS: RES/ACC POLE ~L. DG FOR R¥ STORAGE & GARAGE <br /> <br />1440 <br /> <br />SETBACKS: <br /> <br />~o~ ~ ~c ~.~ .~v. 4/~o OFHCE COPY <br /> <br /> <br />