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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 />The work will be performed by a registered budder <br /> <br />PFI_IJ[;~ HiKE & I, gNCY ' i~ESI~EN'I'];~L <br /> <br /> AU~SVILLE 0R 973~5 MAR[ON COUNTY :N0 ~ <br /> 4 <br /> <br /> SITE HUMBER: 94~82~85 <br /> PHONE." 749-~07 VALUATION: $25~ 928.00 <br /> -:.--%~.x~,,. ............... .................. <br /> ~L-o~k~ <br /> <br />....................................................... : ; ....... <br /> <br />TYPE: BUILDING PERMIT OR APPLICATION HO: <br /> <br />CONTRAC'f'OR, NO. 5220~ <br />William E 6ermomd <br />&~47 Stay,on Rd SE <br />TL~rner~ 97~92-0000 <br />PRONE: <br /> <br /> ITEM <br />BUILDING FEE <br />PLAN REVIE~ <br />~IlIL~IN~ STATE SURCHARGE <br />ZONING SURCHARGE <br /> <br />ARCRITECT/ENG1, NEER, NO. <br /> <br />PRONE: <br /> <br />QUANTITY <br /> <br />TOTAL ASSESSED F[ES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />AMOUNT <br /> $175.00 <br /> $11~.75 <br /> $8.75 <br /> $8.75 <br /> <br />$~06.25 <br />$~06.25 <br /> <br />BALANCE DUE $0.00 <br /> <br />F'AYEE~ PFLUG, MIKE & N~NC¥ <br />RECEIVEB BY~ pm .................................. TYPE: CA CHECK <br /> <br /> * THIS IS NOT A PERMIT. ,.,;'THIS, APPI'~CATION HUST GO THROUGH A REVIEW PROCESS WHERE THE <br />FOLLOWING HUST BE COHPLETE]~ IT 'IS THE RESPONSIBILITy OF THE APPLICANT TO ASSURE THAT <br />LL NECESSARY INFORMATION HAS BEEN PROVIDED, <br /> <br /> PLAN R[VIEW, BY_ _2:D'ATE_-Z~/_/. ~ HEIGHT, SET,ACKS: FR <br /> <br /> : STORIES: 2 RS'-'7~' <br /> PLAN. ACTION: <br /> CITY JURISDICTION: BY_..__ .... DATE___~ ..... ENERGY PATH: =r ............. <br /> <br /> ~LMAkKS. ADD: 2ND STORY, 'SS:AU W/V~T W/BRING IN PUMPeR FORE <br /> <br />FORM # MC 15.56 REV, 4/9n OF F ICE COPY <br /> <br /> <br />