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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 /> <br />SiTuS ADORESS. <br /> <br />SIGNATURE OF APPLICANT. <br /> <br /> DATE: <br /> <br /> TAX LOT. <br /> <br /> CONSTRUCTION TYPE <br /> <br />i R I-"_' S I I) E N "f' I A L <br /> <br />OCCUPANCY: <br /> <br /> UGB. <br /> OCCUPANT LOAD: <br /> <br /> LAkEkOOD =.o~ A~ES <br /> SAME ................................................... <br /> SITE ~UMOE~: 94-82~28 <br /> F'HOHE: ~f~7~-I- 1448 VALUAT'tON: <br /> <br />r i ....... 1. ~ ~,. 4,~ ~W , R,~ 5 R <br />~ WIDTH: :t76 ~DEPTH: XRam': ........... ~h Ifi: ...................... ~E~: 'C~ ........... <br /> ~,D:[ ~JF' YES ~ N0 <br /> <br />TYPE: PLUNBIH~ <br /> <br />PERMIT OR: APPLICATION NO: 56885 <br /> <br />QUANTITY <br /> l! <br /> <br /> T!TAL A,...,!SES!~EI) FEES <br /> PREV,1; 0US ~ECEIPTS <br /> THIS RECEIPT <br /> <br /> [~ALAhtCE DUE <br /> <br />PA YI:; E,~ RECEIRT NO:: <br />REP, F':I:VEI) BY: DM TYF'E: C..HECK <br /> <br />~ THIS IS A VALI9 PERHIT ~ THIS PERMIT EXPIRES 188 DAYS FROM ITS ISSUE DATE. IF <br />CONSTRUCTION CEASES FOR A,PERIO~tOF '188'~AYS~ OR Ir CONSTRUCTION FAILS TO NEET ALL <br />EOUIRENEHT~ OF STATE LA~S AND NAR~ON'COUNTY BUIL~ING AND ZONING OROIHAHCES~ THIS PERMIT <br /> ALL BECOME NULL AN~ VOI~. ' , <br /> <br /> ~)01,iAL~) F. W00DLE¥, ~AR~0N C0tJNT¥ BUiLDIHG OFFICIAl,,, / BY ................................................................ <br /> <br /> OFFICE COPY <br />FORM # MC 1 $.56 REV. 4~90 <br /> <br /> <br />