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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 em performing work on a property I own or occupy. <br />I am a registered builder OR the authorized representative S~GNATURE OF APPLICANT: <br />e a registered builder. <br />Tile work will be perfgrmed by a registered builder. <br /> <br />'ow.~g; I A f E.," 047r~i,/94 <br /> <br />TAX LOT: <br /> <br />~ATEGOR¥: <br /> <br />~IklLING AO0~!6'LE FANtU,;Y OWELt::IN{;'S ...... ~6~6i,,,i{i6~; ....... <br /> <br /> Ai'Ji%¥.,. L LE MEAD~OW,~ <br /> 2493 LATONA CT <br /> I?'IZER, ? 97~0~ SITE HUH~ER: 94-ee835 <br /> F HONE: ~ )~.-787~? VALUATION: $7t, 994,, ~ <br />;LOT: BLOCK~ 8~CTION; : TOWNSHIP: ~ RANGE: ' ZONE: ;~k~; <br /> <br />TYPE: DWELLIN~ PERMIT OR APPLICATION NO= <br /> <br /> ITEl4 <br />1)WELLING BUILDING PEE <br />DWELLING PLUMBING <br />~ELLZNG ~EGHANICAL <br />DWELLING ~LECTRICAL <br />DWELt. lNG STATE SIJRCHARG~', <br />DWELLING PLAN RE¥IEW <br /> <br /> 53191 DP <br />AI?CHITECT/ENSINEER~ NO. <br /> <br />PHONE: <br /> <br />TOTAL ~SSESrEB FEES <br />PRE¥]:OUSRECEIPTS <br />THIS RECEIPT <br /> <br />BALAN¢E DUE <br /> <br />QUANTI~Y A~OUNT <br /> <br /> $~9,,~9 <br /> $24.76 <br /> $77.81 <br /> $23.72 <br /> $185.00 <br /> <br />$683.04 <br /> $0.00 <br /> <br /> $8,,00 <br /> <br /> PAYEE: <br /> R~CEIV['~D BY~ PB TYPE: CHECK ~: 0 <br /> <br />* THIS IS A VALID PERMIT. THIS PERHIT EXPIRES 180 DAYS FROH ITS ISSUE DATE. IF <br />C~N~TRUCTIgH C~S~S ~OR ~ PER,gO ~F ~8~ D~YS~ OR ~F C~NSTRUCT~BN F~LS TO ~ET ~LL <br />EQU~REMEHTS OF STATE ~0S RHD H~ZON COUETY ~U~LDZNG ~HD ZOH~NG O~DIN~NCES~ THIS <br />ALL BECOME NULL AN~ VOID. <br /> HEIGHT: S~,t~ALk,3,,""'"' ' '~" PR <br /> ....~ <br /> TOTAL SQ PT: t6¢4 LS <br /> STORIEO: I RS"'~ <br /> PLAN. ACTION: .... <br /> ENERGY PATH: 1 SF"- <br /> ............ h <br /> <br /> ~..HA~Ko,, NEW <br /> DSNALP i:':., WOODI..,f¥~ HARION COUNTY BUILD~:NG OFFICIAL / BY .....................................................................~ <br /> <br />FORM # MC 15-56 REV. 4/90 <br /> <br />OFFICECOPY <br /> <br /> <br />