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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLOG. NO. 225 <br />220 HIGH STREET Nc: <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE; 588-7904 <br /> <br /> o a registered bul der, <br /> The work will be performed by a registered builder, <br /> Other <br /> <br />OWNEC~'f'E: J. 27~679'4 l' ~ E i J~ 7./,-~- 0'~ i 0 ¢' <br /> <br /> m~ <br /> <br /> 234 N0,, CENTER Sl'. <br /> oUBLIHI TY 97385 8iT/ HUHBER: 94-~2685 <br /> PHONE~ 769-7f~6 ~ VALUATION: $15~ 552. <br /> <br />TYPE: BUILDING FERMIT OR APPLICATION <br /> <br />~0Nl' RACTO!;~ N0. <br />K IL.~tARTT~. PAT <br />234 NO. CENTER <br />SUBLIMITY <br />F'NONE: 769-759~ <br /> <br /> ITEM <br />BUILDING FEE <br />PLAN REVIEW <br />BUILDING STATE SURCHARGE <br />ZONING SURCHARGE <br /> <br />A~CN~TECT/~N&~NE~ NO,, <br /> <br />PFIONE: <br /> <br />QUANTITY <br /> <br /> TOTAL ASSESSED FEES <br /> REVIOUS RECEIF TS <br /> 'TN ~.~ RECEIPT <br /> <br /> BALANCE DUE <br />PAYEE~ KIL, 19AR"(IN~ PAT <br />Rb.i,EIV~.;.D BY,' 's .................................. TYPE: OK <br /> <br /> AMOUNT <br /> $11&~50 <br /> <br /> $5,,8~ <br /> $5,83 <br /> <br /> $283.8? <br /> $100.00 <br /> <br /> $0.00 <br /> <br /> 828~ <br />CHECK ~: 1422 <br /> <br />FOLLOWIM~ MUST BE COMPLETED. IT IS:THE :RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT <br /> LL NECESSARY INFORNATIOH'H~S BEENPROVI~ED. <br /> <br /> ~ DATE , HEIGHT: 14 SET~ACKS~ ' ' FR 20 <br /> PLAN <br /> REVIEW~ <br /> BY <br /> ZONING:, 8Y .......... ~ATE ............... TOTAL SQFT: 17~8-~ L,~o .... .I, 0 <br /> SEPTI6: BY ..........................DATE ................ 4~A~T~: i ~- <br /> LIlY JIJI-~ISDI£;TII~N: BY DATE ENERGY PATH: SI::'~}i/ <br /> <br /> OFFICE COPY <br />FORM # MO 15-56 REV. 4./90 <br /> <br /> <br />