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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 /> D,/.i'l'Eh~ 0:~J295194 'TI:HE:: :10,~].0:,.,~.. <br /> <br /> · ;' CONSTRUCTION TYPE; <br /> ~5 -- N R '-' <br /> t4~ 4TH ~VE N ' <br /> <br /> }~E~RIFIELDS AD)N <br /> ' 692 <br /> PO ~ OX <br /> <br /> ~ KNE,, '749-i~57 VALUATION: <br /> <br /> , ....., .................................... ~ ......... ...... ,, ............... <br />LO~.r ' 9 :25 " OS i2W ' CON <br /> ,. ~ ; <br /> <br />TYP~: BUILDIN~ PERMIT OR APPLICATION NO: <br /> <br />[;O;9!'RACTOR,~ NO., <br />K F¢ 16 H T :, J. [. ,. <br />PO BOX ,692 <br />hU~SV~L]._E 8R 9~;~25 <br />PHGNk, r 749-.-1857 <br /> <br /> I TEN <br /> <br />F'i.,hN REVIEW <br />I-}U~LDtNG STATE SURCF[AI~GE <br /> <br />· 'AYEE:, ixdIbi,. I'. J.l .... <br /> RECEIVED BY: DF <br /> <br /> 9e$7567 <br />ARCHITEC'i"/ENGINI.-]E4;,, NO. <br /> <br />P H 0 N E: <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS Rr:CEtPTS <br />THIS RECEIF'T <br /> <br />[;~UANTiTY <br /> <br />AMOUNT <br /> $17.58 <br /> $ l :L. 38 <br /> <br /> 76 <br /> $~,, 0.~ <br />i~29,, 76 <br /> <br />6~092 <br /> <br /> ¢~FL. IN CHECt< 'k 0 <br />* THIS lo NOT A PERMIT.. ,THIS APPLICATION HUST GO THROUGH A REVIEW PROCESS WHERE THE <br />FOLLOWING HUST BE CONPLETED. IT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT <br /> LL NECESSARY INFORMATIOH HAS BEEN PROVIDED. <br /> <br />'~1:, I.C~ l~;~y ............................. DArE ................... <br /> <br />('..I i'Y -.JL~RiSD'~:C'F:roN: lOT ................ /)ATE ........... <br /> <br />RE. HARK.q: ENCLLtSF:'.:,X,,ST.[NGT ' CAI,,,f' "':,'OR'[ <br /> <br />HEIGHT: ,tO SETBAC. KS: F'R <br />TOTAL S[4 t--T: 272 LS."'/ <br />~TORIE$: i '-~ ..... <br />FLAN. ACTION: RRT_5 <br />ENERGY PATH: Si:' <br /> <br />OFFICE COPY <br /> <br /> <br />