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MARION COUNTY BUILDING INSPECTION <br /> SENATOR BLDG, NO, 225 <br /> 220 HIGH STREET NE <br /> , SALEM, OREGON 97301 <br /> ' PHONE: 588-5147 8:0,0 - 4:30 <br /> 24 HOUR CODE-A-PHONE. 588-7904 <br /> <br />{ IAmperformin9workona roperty l own or occupy, o <br /> / amaregseredbu de O~( } beau hori,edrepre~entsive SGNATURE OF APPLICANT: ~' <br /> The work win be ¢erfotmed by a reSistefed builder <br /> <br /> , ¢~X 6df; ; CAT,CORY', <br /> <br /> 84~8 SILVER F~LLS H~Y SE CONTRACT CI~Y; ~ uae: OCCUPANT LOAD: <br /> AI,t~SVZLLE OR 97~25 (HARION COUNTY~ NO <br /> <br /> OTHE~ NON-RESIDENTIAL BU~LQIHGS <br /> MAILING ADDRESS: <br /> <br /> 1575 CAMBRIDGE DR SE <br /> SALEH~ OR ~7302 SITE NUMBEEt ~4~1~17 <br /> PHONE: 588-5724 VALUATION: $14~ <br /> <br />m I ) <br /> ...................... ................. ,. <br /> <br />TYPE: 8UIL~iHG PE~HIT OR APPLICATION HO: <br /> <br /> C~NTRAgT0~ NO. ~7217 <br /> ierry L. ual"r Co)~struction I <br /> 1537 Webster Dr SE <br />,' Salem~ 97302-0000 <br /> PHONE: 39~-7598 PHONE: <br /> <br /> ITEM <br /> BUll. DING FEE <br /> PLAN REVIEW <br /> BUILDING STATE SURCHARGE <br />'" ZONING SURCMAR~E <br /> <br />PAYEE: LARRY K KEUDELL <br /> <br />ARCHITECT/ENGINEER, NO. <br /> <br />~OTAL ASSESSED FEES <br />FREVIOOS RECEIPTS <br />THIS. RECEIPT <br />BALANOE ~UE <br /> <br />QOANTITY <br /> <br />AMOUNT <br /> $118.50 <br /> $71.8~ <br /> $5.5~ <br /> <br />$0.00 <br />$0.00 <br /> <br /> RECEIVED BY: MB ...................................... TYPE: CK CHECK ~,: 1971 <br /> <br />$ THIS IS NOT A PERI, IT. THIS APPLICATIOH HUST ~o. THROUGH A REVIEW PROCESS WHERE THE <br />FOLLOWTNC HUST ~E COHPLETED. ZT ~S THE RESP~S'[BIL[TY.OF THE APPL~CRNT TO ~SSURE THAT <br /> LL HECESSCRY IHFORHAT~O~ HAS ~EEN: PERIDEX. <br /> <br /> .................. PLAN. ACTION: RR, <br /> CITY JURISQICTION: BY ............. QATE ......... ENERGY PATH: ~ SP ........... <br /> <br />OFFICE COPY <br /> <br /> <br />