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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 H[GH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR OODE-A-PHONE: 588-7904 <br /> <br />of a registered bu der, <br />The work will be performed by a registered bu,/der. <br />Other <br /> <br /> . CONSTRMOTION TYPE: <br /> <br /> US~ OF BUILDING; ~NO O~ BEDROOMS <br /> <br /> MAILING ADOR¢SS'. ~ SUBDIVISION; <br /> <br /> ~--'M~[~"'CR EEK'-ESTA T ES <br /> 7911 SQUIRREL HZLL R~ <br /> <br /> PHONE: 375-8234 ' VALUATION: <br />J ' ~ ~ I <br /> <br />TYPE~ BUILDING <br /> <br />COHTRACTOR~ NO. <br /> Capitol ANlli~g <br />518 va].leywood Dr <br />Salem~ 97~06 <br />PHONE"" ~6~-1711 <br /> <br /> IfEM <br />BUILDING FEE <br />PLAN REVIEW <br />BUILDING STATE SURCHARGE <br /> <br />PERNIT OR APPLICATION NO: <br /> <br /> 9056189 <br />ARCHITECT/ENGINEER~ HO. <br /> <br /> PHONE." <br /> <br /> QUANTITY A~IOUNT <br /> ~38.50 <br /> $25,, ,,33 <br /> <br /> TOTAL ASSESf~.ED FEES $65.46 <br /> PREVIOUS RECEIPTS $0.0e <br /> THIS'RECEIPT $65.46 <br /> <br /> BALA~E DUE $8. B8 .' <br /> <br /> PAYEE: Capitol Awning 58689 <br /> RECEIVED BY: PM - - - -. ~ TYPE: IN CHECK ~: <br /> ............ ........................................ <br /> THIS I~ NoT A PE~T~ :T~IS A~E~C~TZOH ,~UST ~ ~GH :~ R~IE~ PROCESS WHERE THE <br />FOLLOMING HUST ~E CONPLETED. ~T IS, THE RE~SI~IL~TY OF THE APPLICANT TO ASgURE THAT <br /> ~LL NECESSARY INFORHATION ~ :~N' PROVIDED. : <br /> <br /> PLAN REVI/WI DY SETBACKS: FR <br /> ZOH!NG: BY ~8 <br /> SEPTIC: BY ....... .-_ STORIE~: I RS'"'~-- <br /> PLAN. ACTION: RR- <br /> cI'rY JURISDICTION: BY . ____,, DATE ...... ENERGY PATH: <br /> RI:HARKS. CARPORT <br /> <br /> OFFICE COPY <br />FORM # MC 15.56 R~v', 4/$0 <br /> <br /> <br />