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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />920 HIGH STREET NB <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588~7904 <br /> <br />Thc' work will be performed by a registered builder. <br /> <br />DATE: 12Z28/95 . T~.ME.. 16.~1§.51 <br />OWNER; , TAX LOT: CATEGORY <br />HEIDGERKEfl, GEORGE F. ~66845-000 ¢OMNERCI:A[.. <br />I StTUS ADDR~ i CON~OCTI~ TYPE' ' OCCUPANCY: <br /> <br /> BREITEHBtJSN HOTSPRINGS -- '~'~O(~JT¥:~' 'UgB: ' 'O~OUPANTLOAD: <br /> ~ETROIT OR 97~42 HARION COUNTY NO <br /> <br /> HOTEL MOTEL./ TRANSIENT ACCOMMODATION 1 <br /> <br /> ' BREITENBUSH LOWE~ CAHP <br /> PO BOX 608 ..................................................... <br /> SHELTQN WA 98584 , SITE HUMBER: 94-04282 <br /> PHONE: 206-,264-622~ VALUATION: $30,000.00 <br /> <br /> ............... ~.~g ............... ' ?.S ........ 7E TC 102 <br /> <br /> TYPE: BUILDING PER~IT 8R APPLICATION HO: <br /> !g~Z~¢~g~ ARCHITECT/ENGINEER, HO. <br /> FO BOX ~08 <br /> SHELTON WA 98584 <br /> PHONE: 206-264-6 PHONE: <br /> <br /> ITEM QUANTITY AMOUNT <br /> BUILDING FEE $19~.00 <br /> PLAN REVIEW $1~,,~.45 <br /> BUlL. DING STATE SURCHARGE $9,65 <br /> ZONING SURCHARGE $9,65 <br /> <br /> TOTAL ~SSESSED FEES $337,75 <br /> PREVIOUS RECEIPTS $3J7~75 <br /> THIS RECEIPT $0.00 <br /> <br /> BAt, ANCE DUE $0,00 <br /> <br /> PAYEE: <br /> RECEIVED BY: CR .................................. TYPE: CHECK ¢: 0 <br /> <br /> * THIS IS NOT A PERHIT. THIS APPLICATION HUST ~ THROUBW A REVIEW PROCESS WHERE THE <br /> FOLLOWIH~ ~UST BE CUHPLETEg. IT IS THE RESPOHSIBILITY OF THE APPLICANT TO ASSURE THAT <br /> LL NECESSARY [HFORHATIOH HAS BEEN PROVI~E~. <br /> <br />PLAN , vi u: .EIGHT: SET *CI S: ............... <br />ZONING. BY ......... ~ ............. TOTAL SQ FT. 4'2 <br />SEPTIC: BY ............... DATE~ ............ STORIES: 1 RS ............ <br /> ............................ PLAN.ACTION: RR ..... <br />CITY JURISDICTi[ON: BY ........ OATE ..... =__, ENER6Y PATH: sPC'~ii"~i"~ <br /> <br />REMARKS: CABIN ¢ ~ CU.84-55 CONDITIONS NOT MET/ EXPIRE/FORFEIT 12/~8/95,6R NEI::,D,:, SI'I"E <br /> EVALUATION & PERN~T** <br /> <br />OFFIOE COPY <br /> <br /> <br />