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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 /> DATE: 0512'7197 .... --' ..... '*' <br />OWN E R: i~x Lb'd <br /> .dODI)ERN .'4UILDII,16 SYSTEMS,~ tNC &05'18-00(¢1 <br /> <br /> SrTtJS ADDJ~ESS: ] 8ONS+RUCTION ~YPE: <br /> <br /> 949::-1 f:'ORTI'-'R RD SE ; <br /> <br />USE OF aUtLOI~.EZ(;E~ BAI,IK,¢ AND F'ROF'ESS;[ON~L BOZLDZNG9 <br /> <br /> ~ENNETH ¢ RAOMUSSEN~ F'.E. ~2 <br /> FO BOX 250 TUAt, AI']:I4,¢ OR 97862 SITE NU~BE~: ~3-8~828 <br /> PHONE: '74~-4949 ~ VALUAT I ON: <br /> <br />CATEGORY: <br /> LOhMI:RL.~.AL <br /> <br />OCCUPANCY: <br /> B .-. 2 <br />OCCUPANT L~AD: <br /> <br />$/00.00 <br /> <br /> 6 9S ;I.W IL 60 <br />WIDTH: DEPTH; ARBA: ~5. ',UNITSAo j IRF~¥~. LOT: iOO~t~.je4: <br /> <br />TYPE: BUILDING PERMIT OR APPLICATION NO: <br /> <br />(.'X:INTRACTOR., NO. <br />~ODDERN BU:[L]():I:I',II.'; SYSTEMS, IN <br />I~ENNETH ~ RASNUSSEH.~ P~E. 68 <br /> BOX 250 TUAI,..ATIN.~ OF. 9706 <br />PHOHF: 749-4949 <br /> <br /> ITEM <br />BU'IX. DIN{; FE:E <br />PLAN REVIEW <br />BUILDING STATE SURCHARCd: <br />ZONING SUF:CHARGE <br /> <br /> 5~it47372 <br /> <br />A HIfECI/Et,IGIIIEER~ 1,10. <br /> <br />F I-]OI,IE ~ <br /> <br />QUAN'f'~:'f'Y <br /> <br />TI-IlS RECEIPT <br /> <br />FORM # MC ]5,56 REV. 4/90 <br /> <br />A~OtJI,IT <br /> $;!,;% 00 7 <br /> $8,. 45 <br /> $0,, 65 <br /> S0.. 65 <br /> <br />$0.00 <br /> <br />RF_,'MARIfS: MODEI%I BI..DG SYSTEi'iS (i"iODULAR OFFICE II,l--PLANT) NO F'I,,,B~ OR S;iJ, Ii::R <br /> FUTURE WILL REGILIIRE FlEW SEPTIC SYSTEM ~ . / $ <br /> <br /> ,¢...'¢_ / '/, <br /> OFFICE COPY <br /> <br />CITY JURISDICTION: BY .................. DATE <br /> <br />HEIGHT: SETBACKS,~ ER ~ <br />TOTAL SQFT: 720 t,,,SZ'~]~7]]~ <br />STOR T F"S:,, RS ~'_¥~" <br />PLAN. ACTIOH: RR''''*]" <br /> <br /> PAYEE:~ . .. <br /> RECEIVED BY:: (,L. ; TYPE: CHEX:I( ~,: 0 <br /> ~ THIS IS NOT A A REVIEW PROCESS WHERE THE <br />FOLLOWING MUST BE COMPLETED;: II. IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT <br />LL NECESSARY INFORMATION'HAS BEEN PROVIDED. <br /> <br /> <br />