Laserfiche WebLink
MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO, 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-S147 8:00 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am performing WOrk on a property I own or occupy, <br />I am a registered builder OR The authorized representative <br /> of a registered builder, <br />The work will be performed by a registered builder· <br />Other <br />I have read and agree to the terms sta~ed on the reverse side of <br />thio document, <br /> <br />DATE; <br /> <br /> SITU9 ADDRESS~ , CONSTRUCTION TYPE: OCCUPANCY: <br /> <br /> 5'",N <br /> CONTRACT CITY; Od~U'p'AN~ LOAD: <br /> <br /> &UHSV).t. LE. OR 97325 <br /> USE 0¢ BUIL~IN~'. ~NO OF BEDROOMS: <br /> <br />~MAILINe ADDRESS: <br /> <br />hU?tSVZ,M_~L, t)R 97;%':,![~; SITE NUMBER: 94-01538 <br />l'~I'Jt]l,ll!!]l 749-'~72~ ~¢, ~A lOlL $~L~?6~,,eB <br /> <br /> RANGE: ZONe: , MAP'. <br /> : <br /> <br />TYPE.' 8u'rLJ!)IN~, PER~IT OR APPLICATION NO.' <br /> <br />FEE <br /> <br />S7~. E SURCH¢~Rf;f. <br /> <br />g'~54;~52 <br /> <br />PHCtHE: <br /> <br />'rOTmL ~$Gr.'i:SSED FEES <br />PRE¥IOU~ RE. CEI PT.~; <br />THZS F~ECETf, PT <br /> <br />[]UANT:[TY <br /> <br />AftOUNT <br /> 1;44 ,, 58 <br /> <br /> '~2.23 <br /> <br />L~' L RN[ F: 9UE $8., r,3~ <br /> <br />* THIS IS NOT A PiRitll. THiS,APPLICATION HUST 60 THROUGH A RE¥IE~ PROCESS ~HERE THE <br />FOLLO~Ifl~ HUST SE CONP[.ETED. IT IS THE .E£SPONSIPILITY OF THE aPPLICaNT TO ASSURE THAT <br /> LL NECESSARY INFORHATION HAS ~EEN PROVIDED. <br /> <br />HEZ{;HT." 8ETBA(:;KS: f"i:;: 20 <br />TEITAJ.. SF~ F'T: 396 LS'"'2~3 <br />STOR ]ZEAL", J_ RS'"5 <br />F'I &l,i. ACTION: RR'"5 <br />CNER£;Y °A TI-hl SF' '" <br /> <br />FORM # MC t~-S6 REV, *p~O OF FICE COPY <br /> <br /> <br />