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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NQ. 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 />of e registered builder. <br /> <br />Other <br /> <br />I have read and agree to the terms stated on the reverse side <br />this document, <br /> <br />CERNAVA~ JOg'AN .577..4 fC.-r.O 8 f~ ................. RESJ[DENTIAL <br /> <br /> P.O. BOX 759 <br /> AOHSVIL. I.E. OR 97325 SITE HUMBER= 94-82244 <br /> PHONE: 749-18~6 <br /> <br />TYPE~ ~UZL~ZH6 PERHZT OR ~P~LJC~TJON HO: ~S6421 <br />CONTRACTOR. NO. <br />CERNAVA, JORAH mm <br />PHONE:AUMSVZLLE'749-18~60R 9732~ ~ PHONE. ' <br /> <br /> ITEM ~UANT~TY AMOtJNT <br />BUILDING FEE .. <br />PLAN REVIEW <br />BUILDING STATE SIJRCHAR E ,i <br /> <br /> $17.80 <br /> <br />$0.00 <br /> <br />PA,Y, EE= CERNAVA~ JORAN ~:::~ <br />RECEIVE]D BY: PM <br /> ".:: :: TYPE: IN CHECK <br /> <br /> * THIS IS HOT ~ <br />FOLLOWING NUST BE <br /> LL NECESSARY INFORHATII <br /> <br />I <br /> <br />Pt. AN REVIEW:.BY <br />ZONING: BY <br />SEPTIC. BY .............. ~E' <br /> <br />CITY JURISDICTION: BY DATE ENER6Y PATH: <br />REMARKS: ENCLOSE FROHT PORCH <br /> <br />REVIEW PROCESS WHERE THE <br /> APPLICANT TO ASSURE THAT <br /> <br />SETBACKS: F'R 17 <br /> LS""5 <br /> RS-5 <br /> RR ,,~ <br /> S P ].'.'. .......... <br /> <br />OFFICE COPY <br /> <br /> <br />