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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 />Other <br /> <br />OWNER ~ TAX gOT: : CATEGORY; <br /> <br /> , <br /> <br /> 4'2,~ 0HURCH ST <br /> <br /> P0 ~0X 247 <br /> <br /> CL.H.,~.JLL,.,,~ 0~'.. 923~:-., SITE HUM~ER. <br /> ~' 1,0I..E~.. 2 ~.2- ~89 ~ .......................... J ~ ~AL~2 <br />LOT. / ~LO~K: TOWNSHIP. RANGE <br /> <br /> ................ ~ ~,~' <br /> <br />ZONE; i MAP; <br /> ,'ES <br /> <br />TYPE-' BUILDING PERfliT OR APPLICATION NO.- <br /> <br />60d r,'<AC10h. NO,. <br />AUHoVJ;LM~, 1~ ],id:.. DEPT. <br />P0 BOX 2~7 <br />AUF~SV~L[.E. 0~ 97525 <br />PHOH[;;: 749-289~ <br /> <br /> 57216 <br />ARCHITECT/EFIGINEER~ NO. <br /> <br />PHONE: <br /> <br />I'OTAL ASSESSEB FEES <br />F,~E~OUS RECbI~TS <br />THIS RECEIPT <br />'BALANCE DUE <br /> <br />PAYEL: <br />RIi:CE1W~.:D )~)Y: di,~ ................................................................. TYPE; <br /> <br />QUANTITY <br /> <br />CHECK ,Ih" 0 <br /> <br />A M 0 U N T <br /> $19,, ~0 <br /> $12., 35 <br /> $~,. 9,5 <br /> <br />, * THIS IS A VALI9 PERMIT. THIS! PERMIT EXPIRES 180 DAYS FROM ITS ISSUE DATE. IF <br />[,ONSTRUCTION CEASES FOR A PERIOD OF 188 DAYS~ OR IF CONSTRUCTION FALLS TO HEET ALL <br /> <br /> ALL ~[COHE NULL AND VOID. <br /> <br /> ; HEICHT: SETBACKS: FR / <br /> TOTAL, S~ F'T: 8 L,O / <br /> ,Ht,k(,Y PAI'H: ' STORIES: ' RS"/ <br /> <br /> ENERGY PALM. SP <br /> f,'.V. HARKS; Fl..hO POLE <br /> <br /> OFFICE COPY <br />FORM # MO 15-58 REV, 4¢g*0 <br /> <br /> <br />