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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 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> I am performing work on a property I own or Occupy. <br /> <br /> DATE: z,./06/94 TIME: 16:51:3~, <br /> <br /> 5-N M-..I <br /> DETROIT195 BUTTE OR 97~42N- ~[~ CITY; [~S: <br /> <br />pus~ OF au,~:DENTiAL ACCESSORY STROCTURES ' <br /> <br />; PO BOX 336 ~ HAMMOND <br />~ PNOblE = 854-~482 ~ V~L. IJ~TZOH= <br /> <br />IWIDTH: DEPTH: I AREA; [ UNITS, ~ ~¢G, LOT: <br /> ~...,., * ............. . ~ ,, ...................... ~ <br /> <br />TYPE= BUILBIM6 PERMIT OR APPLICATION HO: <br /> <br />CONTRACTOR~ NO. 78247 <br />L~rry V JohY~son <br />PO Box 592 <br />betroi~ 97342-8080 <br />PNONE: 854-~153 <br /> <br /> ITEH <br />BUlL. DING FEE <br />PI..AN REVIEW <br />BUILDING STATE SURCHARGE <br /> <br />ARCHITECT/EhlGII,IEER~ NO,, <br /> <br /> PHONE:~¢,~. <br /> ~O.'=&'O ¢ ~,-tO $38,50 <br /> 2G. $25.07 <br /> <br />TOTAL ASSESSED FEES $65..4~ <br />PREVIOUS RECEIPTS $0.00 <br />THIS RECEIPT $6%.46 <br /> <br /> PAYEE: Lsl'ry V .Johnson ~' 62691 <br /> RECEIVED DY~ PN .............................................. TYPE:~tN CHECK ~ 0 <br />* THIS IS NOT A PERBIT. ,THIS APPLICATIOH HUST'.-60 THROUGH A REVIEW PROCESS WHERE THE <br />FOLI_O~IN~ MUST BE COHPLETEB. IT IS THE RESPOHSIBZLITY SF THE APPLICAHT TO ASSURE THAT <br /> LL NECESSARY IHFDRHATIOHHAS BEEN PROVIDED. <br /> <br />PI_AN REVIEW: BY . DA'TE ;: HEIGHT: <br />ZONING: BY ......... DATE .......... 1 . <br />,, , . ' · :" 'OTAL SO FT. <br />SEPI'I£,: BY .................... BATE--=-'F"'-~ ..... <br />. , .- .......................... - "~ .... ~ PL~N.AOTION: <br />I.,I'IY ,JWRI~DIOTION: BY DATE ENERGY PATH: <br /> <br />REMARKS: <br /> <br /> SETBACKS: FR 20 <br />204 c'""= <br /> R !~ '- 5 <br /> RR-].5 <br /> SP"j <br /> <br />OFPICE COPY <br /> <br /> <br />