Laserfiche WebLink
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 /> , am performing work on a property I own or occupy, <br /> I am a registered builder OR the authorized representative SIGNATURE OF APPLICANT: <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 aide of DATE: <br /> this document. <br /> <br />U'SE 0¢ BUI~.DING: ~00[ BBDROOMS: <br /> <br />MAIUN~ ADDRESS: SUBDIViSiOn: <br /> M]:L,L ERE:EX ESTATES <br /> <br /> WK "¢ ~_..- <br /> 3 ....~., 7 SITE NUN~ER: <br /> <br />P(YI,E." ''" t. II,¢DF.'HAN,I. T?HOTNY <br /> <br />TOTAL ¢~E;SESSED FEES <br />PREVIOUS REC£IPTS <br />THIS RECEIPT <br /> <br />~ALANOE DUE <br /> <br />Q!J~NTIT¥ ~ M t:J L~i'i! 'f' <br /> $ ~. ,, 23 <br /> <br />ZNVOi~CF. NO,~ 6024;l <br /> <br />...................................... :;' ;~L~ ~.Z%t ~ ~ ~'~"~ ~ ~ k~ ::,,:~ ~ ~ ~ ~%~2~ ..................................................................................... <br /> <br /> ALL BECOME NULL AND VOID. ' ' ' <br /> <br />Ii.,, WOFI ITM, NhR]:ON .r;,ouI,fTY I~[JILI)IN£; OFFICIAL / BY ........................................... .~ <br /> <br />OFFICE COPY <br /> <br /> <br />