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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 />I am a registered builder OR the authorized repreoen a ye <br />The work will be performed by e registered builder, <br /> <br /> ~ CONTRACT CITY'. , UGB; ~O~A~T LOAD: <br /> <br />MAILING ADOR~ f~UR~NT ~UBDIVISION'. <br /> <br /> S'I'AYTOH OR 9738~ ~TE NUH~ER: <br /> <br /> YES YES <br /> <br />TYPE: BUILDING PERHIT OR APPLICATION <br /> <br />I..ON~ RAI. TOR~ NO, <br />,,Jerry W <br />PO Box 177 <br />Hill Ci'~%~ <br />PHONE; 327.-2471 <br /> <br /> I'IEH <br />~:~U 2( t_.D I NJ;. FEE <br />PLAN REVIEW <br />)gl]~:!..])];N6 s'rAT£ SURCHARGE <br /> <br /> 58715 <br /> <br />A;:;:CH'I: T E'.'CT/EN G ~ NI~ER ,~ <br /> <br />PHONE: <br /> <br />TOTAL A.SSEBSE~ FEES <br />PREVIOU.~ RECEIPTS <br />:I'H Z ~ RECEIPT <br /> <br />QUANT~:TY <br /> <br />AMOUNT <br /> ¢ 128. '5 <br /> <br /> $&,, <br /> <br />$220. <br />· -'$ :t. 0.43 <br /> <br /> BALANCE DUE $~., 0~¢ <br />F'AYi~,;E':~ Jerry W F,~.'rt'os 62187 <br /> <br /> RECISZV2;D BYe: PM TYPE: IN CHECK ,[,: <br />* THIS IS A VALID PERMIT." THIS PERMIT EXPIRES 188 DAYS FROM ITS ISSUE BATE, IF <br />CONSTRUCTION CEASES FOR A PERIO~OF, 188 DAYS, OR IF CONSTRUCTION FALLS TO MEET ALL <br />EQUIREMEHTS OF STATE LAWS AHB MARIOH COUHTY BUIL~IM~ AND ZONiHG ORDINANCES, THIS PERMit <br /> AL[, BECOME HULL AH9 VOI~. ' <br /> <br /> H~it~H/: SETBACKS: F'F~ I,S <br /> TOTAL SO PT: 7;34 LS"'/ <br />EHERGY PAR-I; <br /> PLA q. ACTIO ~: RR-'/ <br /> <br />REHARKS;~ AI)I~ l'O RESI'AURA~T <br /> <br />~)ONAt._D E.. [¢300LF. Y~ NARIOI,I CO[};,1T¥ BUIIiDING OFF~CtAL / BY <br /> <br />OFFICE COPY <br /> <br /> <br />