|
MARION COUNTY BUILDING INSPECTION
<br />SENATOR BLDG, NO, 225
<br />220 HIGH STREET NE
<br /> SALEM, OREGON 9'/301
<br />
<br /> PHONE: 588-5147 8:00 - 4:30
<br />24 HOUR CODE-A-PHONE: 588-7904
<br />
<br /> amare~[steredbuilderOR( ) the authorized representative
<br />
<br />The work wtll be performed by a registered builder,
<br />Other
<br />
<br />; (1UMSV.!:I,I,..E FIR~Z DEF"f',. ~ ,LOHH[.,~" ......... C, 1A_
<br />/U~E
<br />
<br /> PO BOX 247
<br /> AUI4SVILLE.; OR 977,25
<br /> PHONE= 74Y-2894
<br />
<br />L/2 ................ h- - ;I.~ .......
<br />
<br />TYPE: BUILDING
<br />
<br />VAI,,,UAT I ON ~ $ I, 0&5.00
<br />
<br /> RANGE ' ZONE: MAP'
<br />
<br />.. 2b ....................8_S ........ 2W ................ C ........ 51.
<br />AREA; UNITS; IRREG. LOT 'r CORNER;
<br />
<br />PERHIT OR APPLICATION HO: 9~5721&
<br />
<br />C ,Ill I, RACTOR, HO.
<br />AL MSVIL[..E FIRE DI:,:.PT,.
<br />PO ;BOX 247
<br />AUMSV1LLE, Ol'.,
<br />F'HONE.".
<br />
<br />l'qJ IL])IN~ FEE
<br />PLAN REVIEW
<br />BI.JILI)i[N6 STATE SURCHARGE
<br />
<br />F'AYEI.',,," AUHSV):LL,[~ I; ,.RI,
<br />
<br />ARCHITECT/ENGINEER¢ NO.
<br />
<br />PHONE:
<br />
<br />8UAN'rZT¥
<br />
<br />,$i9.00
<br />$ t2.35
<br />$0,. 95
<br />
<br />TOTAL AS~ESSE9 FEES
<br />PREVIOUS RECEIPTS $0.00
<br />THIS RECEIPT
<br />
<br />~ALAOCE DUE ~0,,09
<br />
<br />59723
<br />
<br /> F,I..6,..[VL.D BY: F'H TYF'E: ZN CHI-'_-tCK ~.: 0
<br />* THIS IS NOT A PERMIT. THIO APPLICATION MUST GO THROUGH A REVIEW PROCESS WHERE THE
<br />F'~LLOWIH~ MUST ~E CD~PLETE~. iT IS THE RESPONSIBILITY OF THE APPLICANT TO A~SURE THAT
<br /> LL NECESSARY I~IFOR~ATION H~S BEENPROVIDED.
<br />
<br /> Z[)i'tlhll;~ BY ..... DATE' ; ......... TOTAL'~Q FT: ~ I,,S"./
<br /> 9FF']'[[': BY .................................. D~TE-7 .................. , STORIES: ......
<br /> m PLAN,, ACTION: RR /
<br /> CI'IY JURISDI[;'f:[ON~ BY .................... DATE .................. EI4ERGY PATH= S'. .....
<br /> ,~(,'tq4~"i~' ;.'L. Ar, POi : ~O~9¢~:O.S: ¢IRE' ~)l~T~:[c'r '~E"'~ '"~,~'....
<br /> - $,~.. CA(,,k,, ,,~EE S]:TE PLAN
<br />
<br /> OFFICE COPY
<br />FORM # MC 1 ~-~ RE'V, 4/90
<br />
<br />
<br />
|