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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: 588-514.7 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />J am B registered builder OR the authorized representative SIGNATURE OF APPLICANT: .... <br />of a registered builder. <br />The work will be performed by 8 registered builder, <br />Other <br /> <br />this document, <br />I)A[,.'.,. :~,1~t;31/94 'I'IHE.~ .~.5,,~,J,,~,~ <br /> <br /> iS-N B,,,.2 <br /> I85 ?TI-.I ~;l' --- <br /> AUM.WILLL OR 97325 [~)~[.E~- ;]~B~'' <br /> <br /> , SNITH'~ 8 ADDIT]:ON <br /> ~8,~8 CO~N~.RO,[AL. ol SE <br /> oALE. fl. OR 77~2 ~ SITE NUMBER: ~4-~386B <br /> PHONE~ 370-78¢2 ~ VALUATION: <br /> <br />I'¥PE= BUILDING <br /> <br />PERHIT O~ APPLICATION NO: <br /> <br />CONTRACTOR. Iq[).. 87705 <br />, ,{I.,. S'[:a nle~ <br /> <br />FHONE: ~6~.-,0856 <br /> <br />ARCHI:'f ECT / EN~.; :ii'lEER., NO,, <br /> <br />PHONE: <br /> <br /> ['rEI4 QUANTITY AMOUNT <br />I)[:NI)L l't'l OF) 1 $:1,0,, 08 <br />BUILiQING STATE SURCHAf~GE !1~0,, 50 <br /> <br /> TOTAL ASSESSED:FEES <br />, PRE¥:[OU8 RECEIPT8 <br /> THIS RECEIPT <br /> <br /> : <br /> <br />$1~I,,5e <br />$10.5~ <br /> $0.0~ <br /> <br />CONSTR~CT~BN CEASES FOR ~ P~iO~ ~F 188 D~YSs O~ IF ~NSTEUCTZON FALLS f~ ~EET ALL <br />/gUZREHENTS OF STA~E LA~S AN9 HARION COUNTY BUIED~NC AN~:ZOH~N6 ORdiNANCES, THIS PEEHIT <br />~/.L ~ECO~E NULL RN~ VO~; ' : <br /> <br /> HE]:GHT: SE'f'BACK~i= FR / <br /> ~OTAL SQ FT: ~ LS"'/ <br /> ENERGY PATH~ , ' PLAN. ACTI:ON. RR""/ <br /> :: :: ENERGY P~TH: SP <br /> RE~,~ARES~ ~EMO -- AUTO F(EPA~R SHOP <br /> <br />FORU ~ u¢ ~.~ Rev. 4/90 OFFICE COPY <br /> <br /> <br />