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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 pet'forming work on a property I own or occupy. <br /> <br /> owN~r~)A)'['.,, J. 0/:1,7/94 TI:ME; I1.;~5:26 TAX ~OT: iCAf~GO~Y: <br /> <br /> 9697 BATES ROAD SE ' CONTRACT CITY: U~8; OCCUPANT LOAD: <br /> AUMSVIL. L,E OR 97~25 ~ARION COUNTY ;NO <br /> <br />" SITE MUHBER: 94-~4~46 <br />: PHONE: 749-2728 VALUATION: $9., ~68.80 <br /> <br />: ; r 31 8S 1W ', gFl ~8 <br /> <br />TYPE.' BUILDING PERHIT OR APPLICATION NO: <br /> <br />£;ONTNACTOR~ NO. 61471 <br /> RESTORATION CONTRACTORS CO <br />PO BOX 120~ <br />SALEM, 97389 <br />~HONE: <br /> <br /> ITEM <br />BUILDING FEE <br />PLAN REVIEW <br />BUILDING STATE SURCHARGE <br />ZOHIN6 SURCHARGE <br /> <br /> 9858979 <br />ARCHITECT/ENGINEER, NO. <br /> <br />PHONE: <br /> <br />TOTAL AG~ESSE9 FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />QUANTITY <br /> <br />AMOUNT <br /> $80.50 <br /> $52.33 <br /> $4.03 <br /> $4.83 <br /> <br />$140.89 <br /> $0..00 <br />$140.89 <br /> <br />BALANCE DUE $~.,~ <br /> <br /> PAYEI~: RESTORATION CONTRACTORS CO ~ _ 61547 <br /> REC;EIVED BY: dM ....................... ~ ..... ~ ...... ~___ TYPE: Cl( CHECK ,~: 13:L7 <br /> <br />* THIS IS NOT A PERMIT. THIS APPLICATION MUST GO THROUGH A REVIEW PROCESS WHERE THE <br />FOLLOWIHG MUST BE COMPLETED. ET IS THE RESPOHSIBILITY OF THE APPLZCANT TO ASSURE THAT <br /> LL H~C~SSA~Y INFORMATION HAS BEEH PgOV[OEO. <br /> <br /> kl:V I,:..'J. 8Y DATE <br />~'.:'-"rI';~ BY].]."-]]]._ ]].],,]:-_'_]]DATE --'-~''' *~-] ............ <br />'; 'TY JURI.,~DI, C1 t )~. BY DATE <br />RF_MARKS: 6ARAI~E <br /> <br />HEIGHT: <br />TOTAL SQ FT: 624 <br />STORIES: <br />PLAN.ACTION: <br />ENERGY PATH: <br /> <br />SETBACKS: F:R ~ <br /> <br /> SF' <br /> <br />OFFICE COPY <br /> <br /> <br />