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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:$0 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />Other <br /> <br />SIGNATURE OF APPLLCANT[ <br /> <br />' ;~RACT CITY: USe; ~'~C~f LOAD; <br /> 11425 EHLEN ROAI) NE , <br /> ~O~A ' .... ..... <br />;us~ o~ ~U,LO,N~; ............. <br /> <br />MAI~ING AOD~B ~UJ_TJ[~J~I,,, STR CTUREB ,SU~mWS~ON: <br /> <br /> 4190 VAN NELL RD <br /> ~)AL_I_.AS.¢ ~R ~73~8 ~ SITE NUMBER: 9~-e144~ <br /> PI'-IOHE: &2~,-,~2 , VALUATION: $227~ 888,. 88 <br /> <br />PERi, IT OR APPLICATION NO: <br /> <br />BUILDING FEE <br />PI.AN REVIEW <br />BUlL, DING STATE SURCHARgf'" <br />~ONING ~URCHAR[;E <br /> <br />PAYEE: <br /> <br /> 54288 <br />ARCHI'fECT/ENG"NEE ~,~ NO. <br /> <br />PHONE: <br /> <br />QUAN'FtTY <br /> <br /> TOTAL ASSESSE~)FEES <br />'PREVIOUS RECEIPT!~ <br /> THIS:RECEIPT <br /> <br /> BALANCE DUE <br /> <br />AMOUNT <br /> $7~,,00 <br /> $489,,45 <br /> $37,,85 <br /> $~7..65 <br /> <br />$I~317,,75 <br /> $0,,08 <br /> <br /> $0.00 <br /> <br /> RECEIVE9 BY: PB ................ ~ .......................... ~ ..... TYPE: SNECK ,~: 0 <br /> $ THIS iS A VALID PERMIT. THIS PERMIT:EXPIRES 188 ~AYS FROM ITS iSSUE BATE, IF <br />COHSTRUCTiOH CEASES FOR A PERIOD OF 188:DAYS; OR IF CONSTRUCTION FAILS TO MEET ALL <br /> EQUIRENENTS OF STATE LA~S AND iNARION COUNTY 8UILOING AND ZONING ORDINANCES, THIS PERHIT <br /> ALL BECO~E HULL AND VOID~ <br /> <br />HEICHT: SETBACKS,, FR / <br /> <br />STORIES,". 1 <br />PLAN. ACTION: RR / <br />ENERGY PATN: SP] ........... <br /> <br />EHERg, Y PATH: <br /> <br />RP_.MARKo. AG STOR BL. D6 FOR FLAY. Bldg 4~2 <br /> <br />'~)ONALD E. WOOI)LEY, MARION COUNTY BI$~I.~)IN60FF'rClAL / BY <br /> <br />OFFICE COPY <br /> <br /> <br />