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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 />HOUR CODE-A-PHONE: 588-7904 <br /> <br />Tile work will be performed by a registered builder. <br />Other., <br /> <br /> AG.I";E,, I-I&RRIE'I , , RESIDEN'fI~L,. <br /> <br /> ~" ' : ~ NO ' <br /> kESZDI J,I l ]kl., ~¢LE.,~(JRY S f ~UOTURE. S <br /> <br /> i HILL CREEK ESTATES <br /> 2~42 BEAVER LP NW <br /> ,~AL,~_n~ OR ')7594 ~ ~IT~ NUNBER: ~4-~4277 <br /> FHONE: J78~3~e8 ' VALUATION: $~,, ~:~ ~,. ~8 <br /> <br />C[!N'F RACTOR,~ NO. 98?40 <br /> Gap~,'bol A~nim] / <br />518 Valle~ood' Dr SE <br />~HON~; 363-I711 <br /> I <br /> <br />f:'L~N <br />BUII,,~ING STATg SURCHARGE <br /> <br />ARCHI'f'ECT/ENG Z NEER~ NO,, <br /> <br />PNONE~ <br /> <br />QUANTITY <br /> <br />I'OTAL ASSESSED FEE9 <br />PRE¥IOU$ RECEIPTS <br />THIS REGE:£PT <br /> <br />AMGUN'f' <br /> $44,, 5~3 <br /> $28,, '72; <br /> $2.. 25 <br /> <br />S75,. 8& <br /> <br />$ f ,I, &6 <br /> <br />BALANCE DUE $8,08 <br /> <br />P~Y¢E'~ Ca¢~tol <br />RFF;E:[VEI~ BY;~ Pff ............ ] .............................................. TYPE: :£N CHE(:K 4:: 0 <br /> <br />$ T~IS ~$ NOT A PERHIT~ THIS APPL~CATIOH <br /> <br />HETGHT: SETBACKS: FR I0 <br />TOTAL SQ F'I': ~l LS" <br />~TORIES: RS'-~; .... <br />F L A N ,, A O T I O N;~ F:R "' l, <br />ENERGY F'A TFI~ SF"" <br /> <br />OFFICE COPY <br /> <br /> <br />