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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 />l lt.)l;A~',~ ¥ ,}ACK
<br />
<br /> 2575 SW PAL, I~;ADFS CREST
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<br />SIGNATURE OF APPLICANT:
<br /> DATE:
<br />
<br />SITE HUMBER:
<br />VALUATION.'
<br />
<br />L~T: ~LGCK; SECTION. ' ........ ~:OW ~-s i~ I'~ ..... RAf~GE
<br /> 11 ~'S ].W
<br />WIDTH DEPTH AREA 2&, uN~ ~r~G. LOT:
<br />
<br />I,IK~,~OWN (,LA, ,.
<br />
<br />OCCUPANCY
<br />
<br />OCCUPANT LOA6
<br />
<br />~'4-0077&
<br /> ~;!46, 250,,
<br />
<br />ZONE; MAF
<br />C~R:
<br />
<br />TYPE: B~ILDINQ PERMIT OR APPLICATION NO:
<br />
<br />li:U II ,I)11,1¢, F'[:'F
<br />F'LAN REV :(I';W
<br />FIRE ANI) i,.IFE SAF['.':'IY RE¥IEW
<br />I:4t.I[LI)ING STATF. SUF(CHARGE
<br />ZON.TI,i(; SI.IRCHARG, E
<br />
<br />AF(c H.T. TE CT/E Nf; :[ NIEE R,~ NCI,,
<br />
<br />PROI,!E:
<br />
<br />TOTAI,.A$SESSED FEES
<br />PREVIOUS RECEIPTS
<br />THIS RECEIPT
<br />
<br />QUANT]:TY
<br />
<br />AMOUNT
<br />
<br /> !i~557, G~
<br /> $228.28
<br /> $27.55
<br /> $27.5~
<br />
<br />$1,18;5,. 59
<br />$],,~ :t. 8S,, 5?
<br /> $~,, ~0
<br />
<br />BALANCE DUE $~;!L, (¢~,')
<br />
<br /> RIi:;CEIVE~) i,,~. PB TYF'E: LHECt ~: 8
<br />
<br />~ THIS IS A VALID PERMIT. THIS PERMIT EXPirES 188 DAYS YROM iTS ISSUE BATE. IF
<br />I;ONST~UCTION CEASES FOR A PERIO~ §F 188 ~AYS,: OR IF CONSTRUCTION FAILS TO MEET ALL
<br /> EQUIREMENTS OF STATE LANSAND MARION COUNTY BUILDING ANDZUNiNG ORDINANCES, THIS PERMIT
<br /> ALL BECOME NULL AN~ VOID.
<br />
<br />EtEI GI.,ll': 0 SETBACK~h: FR...2¢!
<br />TOTAL gQ FT: 8125 LS /
<br />S'¥'OR,'[ ES: 1 R'.~K'" /
<br />PLAN. ACTION: RR'"30
<br />ENER6Y PA TFh'. SIr`. ....
<br /> * g S :[:-i";; .......... ,. ',-/
<br />
<br />..,. ,,,,,K., A]:RF'I.ANE IAN,~A~
<br /> EVA!.uATIoF! I)El,!I ED'
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<br />DO,Y.iAI.J') ~:~:. ~,JOOI)I,,F;Y,,, HAi';'IOH COUNTY BUILDIHG OFFICIAL / BY
<br />
<br /> OFFICE COPY
<br />'C 15-56 R~V, 4/90
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