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MARION COUNTY BUILDING INSPECTION <br />SENATO¢~ BLDG, NO, 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 (3:00 - 4:30 <br /> 24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am a registered builder OH ( ~.,r~ne authorized representative SIGNATURE OF <br />Other <br /> <br />~6~E~: [ ~TRU6TION TYPE: OCCUPANCY: <br /> AUMSVIL[..E OR ~7~;~5 ~AR.LON [,0UNTY fid ~ <br /> RKSIDENT]'A~ A~.{,E,~OkY ~R,;CTURES <br /> <br /> CONTACT: ~ ' <br /> 769~,~e2 SITE NUM~E~: ~ ~ <br /> <br />TYPE: BUILDING PEEMIT OR APPLICATION NO: <br /> <br />¢Oi',!TRACTOR, ,NIl,, 457~0 <br />V'~CI'OR FRAIIK <br />4~,,,~,~ s'r~YTON SCIO DR S <br /> <br />PHOHE~ ..x PF, Oi,E~ <br /> <br />PL.~N REW:EB <br />BIJIL~ZNG STATE SURCHARG~ :: <br />ZONING oURCHARGE z:~ <br /> <br /> F AYI;.E. VICTOR FRANK Wit, <br /> RE.P, EIVEI) DYe. M~ ,,/ <br /> ~ THIS 18 NOT A PERHIT; <br />FOLLOWING flUST BE <br /> LL NECESS~EY INFORHATI~ <br /> <br />ARCHI'FECT/ENG,~ NEER,t hC.. <br /> <br /> {~UANI'ITY AMOUN-f' <br /> $8 ..... <br /> <br /> $4,, '" <br /> $'1 ,~j:l, ,, 5? <br /> <br /> '"~" CHECK ~. 3.4t3 <br /> TYI-E, CK <br /> <br /> g REVIEW PROCESS WHERE THE <br />THE APPLICANT TO A~SUR[ THAT <br /> <br />PLAN REVIEW: BY 1~ <br />zoNIN,,, ~Y ~,4':'T-.:: 864 <br />Fi~PTII%' DY-'-' ~,::,::~;; ~ <br /> PLaN ~CT]OF~ <br />CT'fY JURLSD:fCTION= <br /> <br /> [.~ET~. ACKS.~ <br /> <br /> RS'~7 <br /> <br />,' <br /> <br />FORM # MC 15-56 REV. 4/~0 OF FICE COPY <br /> <br /> <br />