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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 e registered builder OR { ) the authorized representative <br />of a Cegistered builder. <br /> <br /> WARB.j ROBERT & SAI,IDRA i ~ ~ ~ !,~.ESIDENTTAL l <br /> <br /> AUMSVILLE OR 97~25 AUHSVILLE ~NO ~ ] <br />~ MAIL)N~ ADDRESS: SUBDIViSiON; <br /> <br /> < SITE NUNBEE= g4-)~57( <br /> PHDNE= 76?-7744 ~ VALUAT[DN= $3~ ~.~ <br /> <br />TYPE= BUILDING PERNIT OR AFPLICATZON <br /> <br />~;ONTRACTO~ NO. 42256 <br />Del McCormick <br />518 Valleywood Dr SE <br />Salem, 97306-0000 <br />PHONE: 383-1711 <br /> <br /> ITEM <br />BOILDING FEE <br />PLAN REVIEW <br />BUILDING ~TATE SURCHARGE <br /> <br />ARCHITECT/ENGINEER, <br /> <br />PHONE: <br /> <br />NO. <br /> <br />QUANTITY <br /> <br />AMOUNT <br /> $38.50 <br /> <br /> $].,9~ <br /> <br />TOTAL ASSESSED FEES $65.46 <br />PREVIOUS RECEIPT~ $8,88 <br />TNISRECEIPT $65.46 <br /> <br /> PAYEE: Bel McCormick :.: 5.J~,.,~ <br /> RECEIVED BY: PM TYPE: IN CHECK ~: 0 <br />* THIS IS NOT A PERHIT, THISAPP[ICATION REVIEW PROCESS WHERE THE <br />FOLLO~IHS HUST BE THE APPLICANT TO ASSURE THAT <br />LL NECESSARY INFDRHATIONHASBEENPRDVIDED.:' <br /> <br />SETBACKS: PR 10 <br /> LS- <br /> RS""~S-- <br /> RR'"'10 <br /> sP-Z ........ <br /> <br />PLAN REVIEW: BY TOTAL SO PT;. <br />ZONING: BY . ""7/--~--~",DA~E. ,::,--~7~ .... 'HEIGHT: <br /> STORIES: <br />CITY JURISDICTION: BY ........ DATE ........... ENERGY PATN~ <br />REHARKS: CARPORT <br /> <br />OFFICE COPY <br /> <br /> <br />