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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREI:T NE <br /> SALEM, OREGQN 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 688-7904 <br /> <br />of a registered builder. <br />The work w~ll be performed by a registered builder, <br />Other. <br /> <br />~ !,!!~! E:.!: :.!:: h!!!!'..-:~::' ~ , ~ s :~ ~:~'r :r~ ~ ~., <br /> <br /> SITE NUNBER: <br /> <br />LOT'. ~ 8LOOK; BEOTION'. ~ TOWNSHIP: ~ RANG~: ZONE: MAP'. , <br /> <br />~WIDTH: DEPTH: AREA: ~ UNITS ~ IRREg. LOT; ~ CORNER; <br />L ~'~ '~,~ [ ~,, ~0 ~ ~'~ <br /> <br />TYPE; BUILDINg PERMIT OE APPLICATION NO: <br /> <br /> ?058018 <br />ANCHIIEC <br /> <br />PHONE: <br /> <br /> ITEM {?LIAN'FITY AMOUNT <br />BUZLt)INf; FEE ~l;58,, 5~ <br />PLAN REVIEW $25.~3 <br />~UZI_I)I:N~; SI'A'FE SURCHARGE !~:l.,, 93 <br /> <br />TOTAt. A,~S~oEI) FEE:S <br />F' RI'_-':}~/~ 0 Il8 RECEIPTS <br />THZ5 RECEIPT <br /> <br />})ALANCE DUE <br /> <br />· i T THI A L TI O <br /> <br /> PLAN. AC,~ <br />CITY .JJK...~EE).[. . 3T 3~]E ENERGY FA ~; SF" <br /> <br />REMFd~KS;', C,A,, <br /> <br />~osM* uc ~-.~ ~v, ,u~ OFFICE COPY <br /> <br /> <br />