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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 />ota registered builder. <br />The work wilr be performed by a registered buUacf. <br />Other <br /> <br />$ TUS ADDRESS; ! CONSTRUCTION TYPE; ,' OCCUPANCY; <br /> <br /> PHOMI~A 749"291~ V~LUA F],(N. $7~ 776. <br /> <br />TYPE= BUILDING PERMIT DE APPLICATION <br /> <br />COHTF<ACTOFL¢ HO. 91866 <br />TIHO1Hy A., Bh, Rf,.E.Y <br />4932 KALE ST NE <br /> <br />F'HOHE: 390,,-t 006 <br /> <br />ARCHITECT/ENG].NEI;k, <br /> <br />PI,lONE: <br /> <br /> ITEM QUANTITY Ai%]iJFT <br />ItUII._I)£NG FE~'~ $60.50 <br />F'I_~N Ri~;V:[EW $44, ',5;5 <br />BIJ'[LDINr; STATE SURCH~R{;E S3.43 <br /> <br />TO'fA, L, AS~I£SSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECE:[PT <br /> <br />$ :t, 16 ,, 46 <br />$ :i. 1 & ,, 46 <br /> <br />BALAN ,~E DUI{ $~:t,, <br /> <br /> F'AYEE: TIMOTHY A,, BERKEY <br /> RECEIVE'{) !','BY;,, PM ............................................................. TYPF: ;N CHECK ~: <br /> <br />~ THIS ~S HOT A PERMIT; THi~ APPLICATIONtHUST GO THROUC:H A REVIEW PROCES~ WHERE TH~ <br />FOLLOO~N~ ~UST ~E CONPLETED. I.T IS THE' RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT <br /> LL HECESSARY ~NFO~MATI~N HAS BEEN <br /> <br /> '-'-',',',, <br /> F'I,( 4 ~EVIEW:: BY~ DATE~ ,,~ETI. A,.,Ko. FR ;.'¢'" <br /> ZI, [,; BY .................. DA/E'"-'-r~'~-''" ...... ' TOTAL SQFT: 8¢~4 LS"'S <br /> SKP'r].c= ~Y ................... ; .............. 7~ATEZZZ~ %%ZZ STORIES: ~S '"~;~ <br /> .................................. ' ~ ....... PLAN. ACTIOI4: RR"O <br /> CJ., Y .Jr R]'SDICTZO['J~: DY.__r?..: D~TE ENERGY F'ATH~ e'.'-- <br /> <br />OFFICE COPY <br /> <br /> <br />