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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 />The work will be performed by a registered builder, <br />Other <br /> <br /> : TAX LOT: , CATEGORY: <br /> <br />~ : 4~ 4'ft'[ AVE N ' CONT~AET CITY:~ ?~O'~'~i {888~'~ ~o~o: <br />i AdJ'.ISV}:L_LE OR ~7;~25 ~ AUHSVZid,,.E J NO <br /> <br /> ~ HERRZF'ZELDS ADDN <br /> F'I) ~,.OX 6?2 <br /> AUHSV;(LJ..~'.~ OR 97325 ' SITE NU~BER: <br /> F'HCINE ~; 747'-'1857 i VALUATION:', <br /> <br />T <br /> <br /> ITEM <br />HU:[LDD'N¢ <br /> <br /> .L;LI),TN:; STATE SLIRCI,,IAR[:~ <br /> <br /> 57567 <br />ARCH:~:TECT/E:NG:~NEER~ <br /> <br />PHONE: <br /> <br />:TOTAL ASSESSED FEES <br />:PREVIOUS RECEIPTS <br /> <br />NO,, <br /> <br />(;~UANTITY <br /> <br />AMOUNT <br /> ~i~¢;,, <br /> <br /> j $29. '26 <br /> : $2~?,, 75 <br /> <br /> :: <br /> PA"(EE: :: <br /> RECEZVED BY: dM TYPE: CHECK ,S~: <br /> ~ T~tS tS A ~ALID PERMIT.:: ~HIS PERMIT EXPI~E~ ~Se BA~S F~QM ITS ISSUE BATE. IF <br />EQUIREMEHTS OF STATE LA~S, ~D M¢[IDM COUNTY ~I~DIN~ AN~ ZONING OR~I~NCES~ THIS PERmiT <br />ALL ~ECOHE ~LL A~D VOID;:, <br /> <br />FORM tf MC 15.56 REV, 4./¢0 OFFICE COPY <br /> <br /> <br />