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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: $88-5147 8:00 - 4:30 <br /> 24 HOUR CODE-A-PHONE: 588-7904 , <br /> <br />I am a registered builder Ok ( ) the authorized representative S~GNATURE OF APPLI <br />of a registered builder. <br /> <br /> DATE: 11/29/94 'rIME: 18:86:84 I <br />SITUS AI~,~)~_~_k~jAi_j~R~ MARIAN ~; c~ TYPE'. ; ~T]'.AL <br /> <br /> . <br /> ~736 BUTTEVILLE RD NE <br /> <br />JMAILINGAOD~,~.~IGLF FAMILY DI~ELLINGS !SUSmV,S,ON'. <br /> SANE <br /> <br />TYPE: BU~L9IN~ <br /> <br />CONTRACTOR, NO,, <br />NAGEHAUER~ MARIAN <br /> <br />PHONE= 678-5277 ~ <br /> ITEM <br />BUILDING FEE <br />PLAN REVIEW <br />BUILDING - INVESTIGATION/DOUBLE FEE <br />BUILDING STATE SURCHARGE <br />ZONING SURCHARGE <br /> <br />PERMIT OR APPLIC~TION NO: 90~9793 <br /> <br /> ARCHITECT/ENGiNEER, NO. <br /> <br /> PHONE: <br /> <br /> QUANTITY <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIB RECEIPT <br /> <br />BALANCE DUE <br /> <br />AMOUNT <br /> <br /> $50.50 <br /> $2.53 <br /> $2.53 <br /> <br /> $0,,00 <br />$t38.89 <br /> <br />$0.00 <br /> <br /> PAYEE: HAGENAUER,~tCf4~I¢~I) " ' 62508 <br /> RECEIVED BY~ mb [/\/\ t'""]'~ TYPE' CK CHECK ~' ~ <br /> ...................... q,~j';~:~,.,~..~= ................. ............................................................ <br />~ THIS IS NOT A PERHiT. THIS APPLICATION NUST CO THROUGH A REVIEW PROCESS WHERE THE <br />FOLLOWING HUST ~E COMPLETED. IT IS THE RESPONSI,BILiTY'OF THE APPLICANT TO ASSURE THAT <br /> LL NECESSARY INFORMATION NA~ BEEN PROVIDED. <br /> <br />PLAN REVIEW: BY_~'~-~£ D~TE 11 <br /> <br /> PLAN. ACTION: <br />CITY ~URISDICTION: BY .................... BgTE .............. ENERGY PAIH: 1 <br /> <br />REHARKS~ <br /> <br />142 <br /> <br />SETBACKS: F'R,~/ <br /> R,,.?:,,~ <br /> RR,,c~z~ [, <br /> <br /> OFFICE COPY <br />FORM # MC 18.56 R~. <br /> <br /> <br />