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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 /> of a registered builder, <br /> <br />) Other. <br /> <br />SITUS ^~%f~l~lSS'7I¢'[ O~E CON!;;TI~WCI'II]N 90B70080 <br /> CONSTRUCTION TYP~: <br /> <br />CATEGORY: <br /> <br />RESI;OENT IAI.. <br />OCCUPANCY: <br /> <br /> 36~ DF_LMAR -- , , <br /> nqMSV. I!:A .O.E..__gZT 5 ',n MS V!LLE iN,O <br />DUILDING: <br /> <br /> .~ELL.~ ~& ................................ <br /> <br /> ~----- ~ ~T-Z-~-~.8 FI---D ~:~ <br /> 4416 MONROE AV <br /> AOHSV,[LI,.E~ OR ~73,.5 ~ ~ITE HUHBER: <br /> PHONE: 362..,,7888 ~ VALUATION: <br /> <br /> ~D~PT.: FA~ i UN'~ ,~G. LOT; <br /> I i <br /> <br />i '~rRAd~ ~i~Y: i Or~"~'t~ PA N T LOAD: <br /> <br />TYPE: 9WELLIN~ <br /> <br />CONTRACTOR, NO. 86244 <br />Kenneth R Jacobe <br />4.416 Monroe <br />Sale% 97~81-¢000 <br />PHONE: ~62-7880 <br /> <br />PERMIT OR APPLICATION NO.: 9~54876 DP <br /> ARCNITECT/EH;.[NEER~ NO,, <br /> <br /> ITEM <br />DWELLING BUILDING FEll; <br />DWELLING PLUMBING <br />DWELLING MECHANICAL. <br />DWELLING ELECTRICAL <br />DWELLIIIG STATE SURCHARGE <br />DWELLING PLAN REVIEW <br /> <br />PHONEil <br /> <br />TOTAL, ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />QUANTITY AMOUNT <br /> $2S9.42 <br /> $87.30 <br /> $21.75 <br /> $68,17 <br /> $20.,87 <br /> $185.08 <br /> <br />$&22.4'? <br />$~,.,47 <br /> <br /> $0.00 <br /> PAYEE; Kenneth R Jacobe <br /> RECEIYED BY: P~ ........................................... TYPE: IN CHECK ~: <br /> <br />· THIS IS MOT A PERMIT. THIS GPPLICATIOH HUb~F ~ THROUGH A REVIEW PROCESS WHERE THE <br />FOLLO~[M§ MUST ~E COHPLETEB. ~T ZS THE RESPDNS[SILITY OF THE APPLICANT TO ~SSURE THaT <br /> <br />HEIGHT: SETBACKS: FR._20 <br />TOTAL S0 FT: 1488 LS 20 <br />STORIES: 1 RS"]18 <br />:'LAN. ACTION~ RR 5 <br />ENERGY PATH, I SP~', ....... <br /> <br />BALANCE DUE <br /> <br />LL NECESSARY ZNFOR"*TIO. <br /> <br /> PLAN REVZEW: .... <br /> ZONING: BY ~A'fE - <br /> SEPTIC: BYZ-£ZZ]ZZZZ'Z"ZZZZZ ATE'£ZZZZZZZZZZZ'Z <br /> <br />CITY JURI,~DICTION. BY ......... DATE <br />REHAkK. ,, NE:W RES <br /> <br />FORM # MC 15-56 REV, 4/90 OF FICE COPY <br /> <br /> <br />