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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 a registered builder OR ( the authorized representative <br />of a registered builder, <br />The work Will be pedormed by a registered builder, <br />Other <br /> <br /> SITUS ADDRESS: CONSTRUCTION TYPE: OCCUPANCY~ <br /> <br /> , 5_-14 .......................................... <br />' /~2r~ 5TH ST , · j CONTRACT CITY: ~ UGB; ,OCCUPANT LOAD: <br /> <br /> SINL;LE Fg~ZLY D~51.[ zHGS <br /> <br /> ' P.O. BOX.759 ~ ......................................... <br /> AU~SV~LI..~. SR ?7325 ~ S~TE NUHBER~ 94-82244 <br /> PHONE: 749-18B6 j VALUAT~OH= $4~8&~,,~ <br /> <br />TYPE: BUILOING <br /> <br />CONTRACI'SR~ NO. <br />CERNAVA. JORAH <br />P.O. ~OX 7~9 <br />AIJ~SVZLLE~ OR 97325 <br />PHONEs 7~9-1806 <br /> <br /> 1TEH <br />BUll. DING FEE :': <br />PLAN REVIEW ' !::; <br />BUlL. DING STATE SURCHARGE <br /> <br />PERHIT OR :APPLICATION NO= 5§617 <br /> <br /> ARCHII'ECT/ENGIHEER~ <br /> <br />P~YEE: ~, <br />RECEIVED BY: LD <br /> <br />* THIS iS A VALID <br />CONSTRUCT'rON CEASES FOR <br /> EI~UZREHEHTS DF STATE <br /> ALL BECOME NULL AND <br /> <br />ENERGY PATH: 1 <br /> <br />HQ. <br /> <br />D(:)NAI, D E, <br /> <br />QUANTITY ANOLtNT <br /> $2.53 <br /> <br />TYPE: CHECK ~: 0 <br /> <br /> ITS ISSUE DATE. IF <br /> FAILS TO MEET ALL <br /> <br />$85,86 <br />$85.86 <br /> $0.00 <br /> <br />~!ZONING ORDINANCEB~ THiS PERMIT <br /> <br />, ' SETBACKS: FR 20 <br />~T:f 108 LS"'5 <br /> 1 R0"5 <br /> i SF'::[ ........... <br /> <br /> ENERGY PAI'H: <br /> <br />UTLFCFY <br /> ROOM <br /> · <br /> <br /> MgR;[6i~'CSU BUlLD~,N6 'I~I, F1C~L / B'Y ......................... <br /> <br />~ORM # ~c ~s-~s'~m',,~/~ OF FICE COPY <br /> <br /> <br />