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MARION COUNTY BUILDING INSPECTION <br />SENATQR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br />I em a registered builder OR ) he au I~or zed representat ve <br />of ~ registered builder. <br />The work win be performed by a registered builder, <br />Other ..... <br /> <br />this document, <br /> <br /> PHONE: 588-5147 8:00 - 4:S0 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> SIGNATURE OF APPLICANT'. <br /> DATE; <br /> <br />DATE.- 11/07/94 TINE: 10=24-"47 <br />KEIZER BUILDING & DFSI[;N RESIDENTIAL <br /> <br /> SINGLE FAHIL~Y DWELLINGS ,J ~o. OF 3 <br /> ~VILLE MEADOWS <br /> PHONE: ,, VALUATION~ <br /> <br />TYPE= DWELLIN~ <br /> <br />CONI'RACTOR~ NO. 63578 <br />MiNe Kubish~a <br />~18 Appleblossom Ave N <br />Sale% 97~0~-0000 <br />PHONE: 370-6716 <br /> <br /> I TEN <br />DWELLIN[;- BUILDING FEE <br />DWELl. lNG PLUM1BING <br /> <br />DWELLING MECHANICAL <br />DWELLING ELECTRICAL <br />9WELLINC STATE; <br />D~EI. LING PLAN REVIEW <br /> <br />PAYEE: <br />RECEIVED BY: DF <br /> <br /> * THIS ISA VALID PERHZ' <br />CONSTRUCTZON CEASES FOR <br />EQUZRE~ENTS OF STATE <br />ALL ~ECOHE NULL AND <br /> <br />~;NERGY PATH: <br /> <br />ARCHITECT/EhGINEER~ NO. <br /> <br /> QUANTITY AMOUNT <br /> $256.63 <br /> <br /> ::: $23.31 <br /> ': $73.07 <br /> <br />~,: $185. ~0 <br />EF's $65~. 92 <br /> $653.92 <br /> <br /> ~.~ <br /> ~ TYPE: CHECK ~: ~ <br /> <br />IF <br /> <br /> ION FRILS TO NEET ALL <br />ZONINI; OI~iDINANCES~ THIS PERMTT <br /> <br /> SETBACKS.- FR 20 <br /> PT: 1595 LS"'5 <br /> 1 ~S"5 <br /> SP'- <br /> <br />REMARKS." <br /> <br />DONALD ,,i:. <br /> <br />~O~M # ~C ~S.~ R~V, ~ OFFICE COPY <br /> <br /> <br />