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MARION COUNTY BUILDING INSPECTION
<br />SENATOR BLDG. NO, 225
<br />220 HIGH STREET NE
<br /> SALEM, OREGON 97301
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<br /> PHONE:588-5147 8:00- 4:30
<br />24 HOUR CODE-A-PHONE: 588-7904
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<br />Other
<br />
<br /> DATE;;
<br />OWNER: i"]0I)gE;]::~["l ~-:IUILDING ,,~YSTE. MS,
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<br />SIGNATURE OF APC'LICANT;
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<br /> DATE:
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<br />SITUS ADDRESS:
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<br /> 949:5 PORTER RI:) SE
<br /> AUMSVILLE~ OF( 97225
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<br />~O~STRUGTIGN TYPE: , OCCUPANCY:
<br />5-N : r~-2
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<br /> ........................ NO O~ BEDROOMS:
<br />uss oF su~t-o~-i.:l. CE,i , ,
<br /> "., - I~AIIK,, AMI) PROFESSIONAL BUILDINGS
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<br /> MAILING AOORESS; SU 8DIVISION;
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<br /> KEliNETH A RASHUoSI:N~ P.E.
<br /> PO BOX ~5¢ TUALATIN,~ OR ~78,$2
<br /> PHONE= 749-4949 VALUATION= $:L
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<br />LOT' : BLOCK: SECTION: TOWNSHIP: RANGE: ~bhE: MA~:
<br /> 6 9S iW IL. 60
<br />WIDTHr ,DEPTH: ~RE~'. '.' I~ 'l_~; 7~: ,
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<br /> TYPE: BIJILBIM6 PERMIT OR APPLICATII~N NO: ~47~74
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<br /> CONTRACTOR. NO. ~ ARCHITECT/ENG~,NEER~ NO.
<br /> HODDERN BUILD]:I,IG SYSTEHB~ IN
<br /> I(EIINETH A RAoMUSSEN~ P,.E. ~8
<br /> PO BOX 2Se 'FUALAI'II% OF(
<br /> PHONE: 749-4949 PHONE:
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<br /> ITEM QUANTZ'f'Y A ~(:]l,ll,ll'
<br /> BUILI):[N6 FEE $25,, 58
<br /> PLAN kEV,JEW $15.28
<br /> BU]:I. DIN6 STATE SURCHARGE $],.
<br /> ZONING SURCHARGE $:1,.
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<br /> PREVIOUS RECEIPTS
<br /> THIE RECEIPT $41,,14
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<br /> PAYEE= MODDERIq BUILDI~IG SY~ITE
<br /> :: : .....
<br /> RECE:[VED BY: Gl_ TYPE: CK CHEC, K ~: 54791~
<br /> ............................................... ........................... ~ .......................................................
<br />* THIS IS HOT A PERMIT,:: THIS ~PBLICATION HUST ~O ~HROUCH A REVIEW PROCESS WHERE THE
<br />FOLL~W[HG MUST BE CQHPLETED;, IS THE RESPQHSIB~L~TY ~F :THE APPLICAN~ TO ASSURE THAT
<br /> LL NECESSARY INFORMATION HAS BEEN PROVIDED.
<br /> F'LA~ ~v~,j~.... ~ ~A~ q~lJ~: H~.'~': S~rI~,AO<S: FF~ [
<br /> ~o~,:~,~,, ~:::::::::::: ~:~zzs:~: ~o~ ~ ~-, ~ L~'r' ....
<br /> SEPTIC: BY STORIES: ~S'~ .......
<br /> ........................................................ F'LAI,I. ACT ION:
<br /> CITY ,JUR]:,,~DICT:[ON. BY ~ATE ENERGY PATH: SP,,,,...~.
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<br /> RE~ARM~:~O~ULAf~ B[_D~ SYS'fEHS (OFFICE 1448S~ FT NEXT TO EXIST:~NG OFF)I,10 PI,,BG & SEWER
<br /> UPS
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<br />OFFICE COPY
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