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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 />{ am ~, eg stered bu der' O~ the au horized rep esentative SIGNATURE OF APPLICANT: <br />of a registered builder <br />The wor,k will be perfor'med by a registered builder. <br />Other <br /> <br />this document. <br /> <br /> OWNER: DATE: 02/23/94 TiM~.: 9. ~6:-4.~,, ....... i' 'fik' E6¥i .............. ]'0AfE~8~%i <br /> <br />:'~iiU$ XDDRE~S: I CONSTRUCTION TYPE~ l <br /> , OCCUPANCY: <br /> <br /> AURORA OR 97002 ~ARZO~ COUntY ~O ~ <br /> usa o~ au ~mNS; <br /> <br /> 2575 SW PALISADES CREST DR <br /> LAKE OSWEGO, OR 97035 SITE ~BER: 94-00776 <br /> P~ONE: 638~8881 VAhUATZON; 8i46,250.00 <br /> <br />TYPE: BUILDING PERMIT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO, 37543 /7 _ <br /> Oregon Pae&~&c ConstructioD// ~/ <br /> <br />~ooaburn, 97071-0000_~ <br />PHONE: 98~8147 ~¢ <br />BUILDING FEE <br />PLAN REVIEW <br />FIRE AND LIFE SAFETY REVIEW <br />BUILDING STATE SURCHARGE <br />ZONING SURCHARGE <br /> <br /> 9053092 <br />ARCEiTECT/~NGiNEER, NO~ <br /> <br />PHON.~. <br /> <br />PAYEE: OREGON PACIFIC CONSTRUCTION <br />RECEIVED BY: PM <br /> <br />TO~AL ASSESSED FEES <br />PREVtOUSRECEIPTS <br />THiS RECEIPT <br /> <br />BALANCE DUE <br /> <br />(¢UAN: -- T. <br /> <br /> I55 .50 <br /> 35~.S3 <br /> $220.20 <br /> 27.53 <br /> 27.53 <br /> <br />$1,183.59 <br /> S0.00 <br /> <br /> $0.00 <br />55553 <br /> <br /> TYPE: CK CHECK #: 2&675 <br /> <br />* TNIS IS NOT A PERMIT. THIS APPLICATION MUST GO TNROU~E A REVIEW PROCESS WMERE THE <br />FOLLOWING MUST BE COMPLETED. IT IS TNE RESPONSIBILITY OF TNE APPLICanT TO ASSURE THAT <br />LL NECESSART INFORF~A?iON ~AS BEEN PROVIDED. <br /> <br />P.uAN REVi.~W.,~Y <br />ZONING: BY_~ i DAT~ <br />SEPTIC: BY DAT~ <br /> <br />CITY JURISDICTION: BY DATE <br />REMARKS: AiR~DANE HANGAR, SE; SS <br /> <br />SSI T: SE? ACKS: <br />::TOTAL SQ FT: 8125 LS-"--' <br /> STORIES. i <br /> PLAN.ACTION: RR_--~_, <br /> ENERGY PAT~: S° <br /> <br />FORM ~ MC 15.58 REV, <br /> <br />OFFICE COPY <br /> <br /> <br />