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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 - 4:3,0 <br /> 24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am a registered builder OR ( ) the authorized representative ~IGNATURE OF APPLIC .,~,....___ .. ~~,,.. <br />of ~ registered builder. <br />The wor~< WIll be performed by ~ registered builder, <br />OtHer , <br />I have read a~d agree to the terdns stated on the reverse side of g ~ <br />this decunqent, <br /> <br /> DATE= 03107194 TI:HE,. 1.2:47."05 ~ <br /> <br /> ~771. DE~WNELL _~R ............... SI ) <br />',d~ o~ su"/°~ff~,JMSVit_LE OE ~7725 N~RION COUNTY NO <br /> <br /> R,,:.', TIAI,, ACCESSORY STRUCTURES I <br /> ~ SITE NU~BER= 94-8~649 <br /> <br />5. AC NO YE,~ <br /> <br />TYPE= BUILDING PERNIT OR APPL[CATIOH NO: <br /> <br />COHI'RAC'FOR~ NO. 45790 <br />VICTOR FRANK WILSON <br />41155 STAYTON SCIO DR S <br />SI'AYTON, 9758~ <br />PHONE; <br /> <br /> ITEM <br />BUILDING FEE <br />PLAN REVIEW <br />BUILDING STATE SURCHARGE <br />'./_ON I NG SIJRCHARGE <br /> <br /> ?853326 <br />ARCHITECT/ENGINEER~ NO. <br /> <br />TOTAL ASSESSED FEES <br />P:RE¥.IOUSRECEIPTS <br />THIS RECEIPT <br /> <br />QUANTITY <br /> <br />AMOUNT <br /> $62.50 <br /> <br /> $3.1~ <br /> <br />$109.39 <br /> $0.00 <br />$10~.S9 <br /> <br />DALAHGE DUE $0.0~ <br /> <br /> FAY_E, VICTOR FRANK WIZ-~ON <br /> RECEIVED BY;: ~B }/~A V.,). TYPE': CK CHEC;< ~: 27~ <br /> <br />* THIS IS NOT A PERH[T. THZS APPLICiiTION:HUST ~ THROUGH A REVIEW PROCESS WHERE THE <br />FOLLOWING HUST 8[ COHPLE~ED. IT IS THE RESPONSIBILITY OF THE APPLICAHT TO ASSURE THAT <br /> LC NECESSARY iNFORHAT~ON HAS BEEN P~VIED. · <br /> <br /> F'L,~N REVIEW: BY <br /> <br /> PLAN. ¢C'f~ON~ R R,,~,4 ..... <br /> CITY JURIS~ZO1].ON~ BY ................. 9hTE .................... ENERGY P~Ti.,I~ Si,-'. ........... <br /> <br /> REHARKS~ GARAGE <br /> <br />FOR~ ¢ MC ~s-~ R~V, 4¢~o OFFICE COPY <br /> <br /> <br />