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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 />of a registered builder, <br /> <br />Other_ <br /> <br />I have read and agree to the terms stated on the reverse Side of <br />this document. <br /> <br />!~wNE~ATE.~ 09/27794 TT~E:' 11~,'0S:"32 ..... l~;~x L~'¢: ,~ATE~oRY: <br />ISITUSi ~:~ ~'~8171 <br /> <br /> AUMSVIL. LE <br /> <br /> 1137~ HILL CREEK <br /> AUMSVIL. LE OR 97325 ~ SITE NUHBER: 94-e3774 <br /> PHONE: 769-7744 <br /> <br />TYPE: BUILDIHG PERNIT OR APPLICATION <br /> <br />CONTRACTOR, NO. 9894B <br /> Capitol Awning / Santiam Ho <br />518 Valleyeood Dr SE <br />Saie~ 9730~ <br />PHONE: ~6J-1711 <br /> <br /> ITEM <br />BUILDING FEE <br />PLAN REVIEW <br />BUILDING STATE SURCHARGE <br /> <br />PAYEE: Cmpitol Awning / San~iam Homes <br />RECEIVEB BY: DF <br /> <br /> 9858474 <br />ARCHITECT/ENGINEER~ <br /> <br />PHONE: <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />BALANCE BUE <br /> <br />aUANTITY <br /> <br />AMOUNT <br /> $38.58 <br /> $25.83 <br /> $1.9~ <br /> <br />$65u46 <br /> $0~00 <br />$65.46 <br /> <br />61825 <br /> <br /> TYPE= IN CHECK ~: 0 <br /> <br /> CONPLETE". X' ~S THE, f~cSPI~SIBILITY SF THE APPLICANT fO ASSURE THAT <br />LL NECESSARY INFORHATTOH NAS BEEN PROVISED. ' <br /> <br /> ~=PtAN REVIEW: BY T ICNT: 1~ SETBACKS: FR 10 <br /> <br /> . PAN. AOTIO . <br /> CITY JURISDICTZOH. BY ........ ~ATE ....... E~ERGY PAl'S: 8pz/RE-1B <br /> REMAKES: CA~PORT <br /> <br /> OFF[CE COPY <br />FORM # MC 15-56 REV, <br /> <br /> <br />