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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO, 225 <br />920 HIGH STREET NE <br /> SALEM1 OREGON 97301 <br /> <br />The work will be performed by a registered builder. <br />Other. <br /> <br />this document. <br />D~TE: 05/~2/?~ T 1 ~E',' <br />OWNER:SMITH. ,JAME!] qLLEN ~' ' <br /> <br /> [~470 LAKEWOOD DR NE <br /> AURgRA OR <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />~CC~ PANT LOAD: <br /> <br />usg OF eu~;B~GI...E ::'AMILY DWELLINGS <br /> <br />F"HONF'r. <br /> <br />&78,,,J. 450 <br /> <br />LO~3/4 ~ ~c, SgCTION:22 T6 W~F'c .... R~NGE:lW ' , ZONE:RS MAP[5 <br />WIDTH ~'~l DEPTN: 201 ' AREA ........... U N I"~~' I~.~_ ~}.' L 0''' CC~SER: <br /> <br />TYPE: 8UILgING PERHIT OR APPLICATION HO: 9854754 <br /> <br />CONTRACTOR~ NO. ARCHITECT/EHE-:[NEER, NO. <br />SM'.[TN~ JANES ALLEN <br /> <br />PNQI, IE: 678-1450 PHONE: <br /> <br /> I ']'EH <br />BUILDING FEE <br />PI. AN REVIEW <br />BUILDING STATE SURCHARGE <br />ZONING SURCNARGE <br /> <br />PAYEE= SMITH, ,JA~IES ALLEN <br />RECEIVED BY,," c12 <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUSRECEIPT~ <br />TH~S RECEIPT <br /> <br />B~LAliCE DUE <br /> <br />QUANTITY AMOUNT <br /> $4.33 <br /> <br /> $0.00 <br />$151.~9 <br /> <br />$0.00 <br /> <br />57428 <br /> <br /> ................... ; ....................... ==__~__ TYPE: CE CHECK ,~: 1&1,8 <br />THIS IS NOTA PERMIT. THIS RPPEIcATIOMiHUST~O THROUGH A REVIEW PROCESS WHERE <br /> <br />ZONIbIG~ BY,.,,.~"-~'~'];-_~_-: DATE?A.,;'T'J'T~'i,'-"'-/: TOTAt, SQFT: <br /> STORIES: <br /> PLAN. ACT]CON: <br />CITY ,JURISDI(3TION: BY ........... ~D~TE ............... ENERGY PATH: <br />REHARKS: RES/ADD EXTENSION OF BEDRM, CLOSET AND BATHRN <br /> 4' ,,Jo <br /> <br />1 <br /> <br />224 <br /> <br />SETBACKS. <br /> <br />FORM # MC 15-56 REV, 4/9o <br /> <br />OFFICECOPY <br /> <br /> <br />