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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 />I am performing work on a property I own or occupy. <br />I am a registered builder OR the authorized represen ave <br /> of a registered builder. <br />The work will be performed by a registered builder. <br />Other <br />I have read and agree to the terms Stated on the reverse side of <br />this document. <br /> <br />OWNER;~)¢~.'~'~:~:f ~i:~:/~.~.~/4p4~ , -~.. . <br /> <br /> ~,~uTt..~:~' -' "" '~,- ' ~'. . <br /> ]R 97~,,,) AUM,~VIL.E ND <br /> <br /> ~U~SVtLi,,,IF:,, rjr 97325 <br /> - , VALUATION= $;'5. ~. ~8 <br /> <br /> TYPE: BOILBIH6 PERMIT OR APPLICATEOH NO: 57188 <br /> OONI kAglO~,~ NO. ~8~4~ ARCHI'FECT/EN~;INEER~ <br /> <br /> F't, IONE: 36;~--"i / :1.1 PHONE: <br /> ]:'I'EH QUAN'fZTY AHOUNT <br /> BUI[_D~h(G FEE <br /> <br /> );d.ll),,~tN6 STATE SURCHARGE <br /> <br /> TOTAl ASSE~SE~ I::'iEES $65.46 <br /> FREV~OUS kECE~PTo <br /> THIS .RECEIPT <br /> <br /> BAL:ANCE ~tJE <br /> PAYE. E: <br /> RECE. IVE~) BY: DH TYPE: CHECK ~: <br /> * THIS I~A VALID PERHIT, .. THIS' PERMIT EXPIRE~ 188 DAY~'FRQM ITS ISSUE DATE. <br /> CONSTRUCTION 6EASES FOR A P/REOD' OF,'['88 BAYS,' OR 'IF CONSTRUCTION FAILS TO MEET ~LL <br /> EGUIREHENTS OF STATE LA~S AH~ NATION COUNTY B~ILDING AND ZONING OR~INANCES~ THIS PER~ZT <br /> ALL BECOHE NULL AND VOID. <br /> <br /> " ~ HEIGHT,:' ' ..... c'. <br /> , ' TQT~L SQ FT: 388 SEFBA[,K,.,. FR..s,.~ <br /> PLAN. ~CTION: RR-"tb <br /> ENERGY F Al H. ~ SF;'"' <br /> d,.MAF k J,, CAR','~Or: F <br /> <br /> OFFICE COPY <br />~ORM # MC tB-~B SEV, 4~o <br /> <br /> <br />