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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 />of a registered builder. <br />The work will be per;ormed by a registered builder. <br />Other <br /> <br />G~T,AOTClTY. U~E ~UPA,T LOAD· <br /> <br /> -H(]JH:~ 74~2--'~4~4 VALUATJ;ON: $12~ 8~. 8~ <br /> ...................... 8LOOK . <br /> LOT. ' ................. ~I'ON; ............ ~o~'~'l~' ............... RANGE: ; '~'~ ...... ¢ MAP: <br /> <br />...... L,'i~ ............ /¢.~ ................. 8~:: ............ LXE& ........ LJ:IO .............. <br /> <br />TYPE: BU1rL])IHG <br /> <br />WOODWAR;D,~ <br />P.t% :(~8X 287 <br /> <br />F'HOHF.. 749-<~;404 <br /> <br />PERMIT DR APPLICATION NO: ~2e5~722 <br /> <br /> ARCH I'f'IECT/EI~R; 1NEEI;;~ I'lO. <br /> <br />PHONE'.' <br /> <br /> ].TEt4 £,!UANTITY A~OUNT <br /> <br />PLAN RE.V 2EW <br />8U'[I,,~ING STATE SURCHARGE <br /> <br />F'AYF'IE:~ WOOi')!,JfiRD,¢ MICHAEl. <br /> <br />TOTAL ASSES$E]D FEES <br />PREVIOUS RI?~CE):PTS <br />THIS RE6~ IFT <br /> <br />$:t, 57.26 <br />$1 iT,, ~,6 <br /> <br />_~ALAHCE {)lie sO. 00 <br /> <br />~ THIS I~ ~OT A PERH~T. :THIS APPL~CATI~ HU~T GO THROUGH 'A ~EV~EW PROCESS WHERE THE <br />FOLLOWING ~UST BE COMPLETED. IT ~S THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT <br /> LL NECESSARY INFORMATION HA~ B~EH PROVIDE~. <br /> <br /> L~ 0 <br /> E¢I:P'I ] C; BY .............................. 7"" ~ATE .................... S"ORIES: . RS'-8 <br /> CT'fY JtJI:~]'SDICTION~ ~Y ~A'f'E ENERGY F'~TH~ ,,~ ..... <br /> RI::'PihRKS ~ STORh[;E <br /> <br />OFFICE COPY <br /> <br /> <br />