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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 />I am performing work on a property I own or occupy. <br />~ ~m a registered builder OR he au ilor zed rep e~en ave <br /> of a registered builder, <br />Tile work win be performed by a registered builder. <br />Otiler <br /> <br />th~s document. <br /> <br />SIGNATURE OF APPLICANT[ <br /> DATE: <br /> <br />JACK <br /> <br />TIME: <br /> <br /> 14397 KEIL RD <br />AURORA OR 77002NE <br /> <br /> f~X LOT; <br /> <br /> i 06E§T~bC'no~ TY~E; <br /> <br />MARION COUNTY NO <br /> <br />. ~kILINg ~'6~ZC'WQRKS 'AHD i SUBDIVIBIdN: <br /> <br />CATEGORY: <br /> <br /> 2575 SW PALISADES [;REST DR <br /> ~AKE OSWEGO. OR 97835 SITE NUMBER: 94~8B776 <br /> HONE= &~8-8881 VALUATION~ $0.00 <br />;LOT: I BLOCK; : SECTION; i TOWNSHIP: ] RANGE; ZONE: MAP; <br /> / ............................ 2~.--..!. AC :NS N8 <br /> <br />TYPE: BUILDING <br /> <br />CONTRACTOR~ NO. 37543 <br /> Oreqo~ Pacific Construction <br />188 S Pacific H~y <br />Woodburn. 77071~0000 <br />PHONE: ~8~8147 <br /> <br /> ITEM <br />ADDITIONAL BUILDING FEES <br /> <br />PERMIT OR APPLICATION HO: <br /> <br /> 58328 <br />ARCHITECT/ENGINEER, NO. <br /> <br />PHONE: <br /> <br />PAYEE: <br />RECEIVED BY: DM <br /> ........ ___~;2~ _ ...... '~: TYPE: <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br /> BALANCEDUE <br /> <br />QUANTITY <br /> <br />CHECK <br /> <br />AMOUNT <br /> $40.00 <br /> <br />$40.00 <br />$40.00 <br /> $0.00 <br /> <br /> $0.00 <br /> <br />CONSTRUCTION CEASES FOR A PERIODOFI~SBAYS; ORIF CONSTRUCTION FAILS TO NEET ALL <br />'[QUIREMENTS OF STATE LA~S ~HD:HA~iOHCOUHTY BUiLSIHCAHSZONIHG ORDIHAHCES~ THIS P/RH[T <br /> ~LL BECOME HULL AHD VOID. <br /> <br />ENERGY PATH: <br /> <br />REMARKS: NEED STAMPED PLANS <br /> <br />HEIGHT:. SETBACKS: FR ........ <br />TOTAL SB FT: 0 LS <br />~TORIES: RS <br />PLAN. ACTION: RE ........ <br />ENERGY PATH: <br /> <br />~ONALD E. WOODLEY~ MARION COUNTY BUIL~IN6 OFFICIAL / BY <br /> <br />OFFICE COPY <br /> <br /> <br />