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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO. 225 <br />220 HIGH GTREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />The work will be pedormed by a registered builder. <br /> <br /> DA?E: 09128194 TIME: 7:46:15 ; j <br /> <br /> 5-N B-2 <br />use OF BuI~SVILLE OR ~7~25 AUHSVILLE NO '~ o~ ~00~s: <br /> <br />i~'~i~l'h'&"~O~.~ES: ............................................. AND OTHER MERCANTILE BUILDINGS <br /> <br /> J NERRIFIELDS ADDITION <br /> 1550 TUMALO DR SE i' . <br /> ~ ~ ~ SITE HI,~BER. <br />............ PHON~ .]'~e~;~288~ i ~E6~i~'~'i I TS~R ~i-: .......... '¢~ht~ZON: ~6~l-. $5.TT§B-; -~ ~: <br /> <br /> ............... ~ ~-~ ............ I ........................... ,~.~, ~ .................... <br /> <br />lOB lB8 18888. SF NO YES <br /> <br />TYPE: BUILDINg PERMIT OR APPLICATION <br /> <br />CONTRACTOR. NO. 82838 <br /> Slate & Slate Construction <br />1~671S Butte Creek Rd <br />Scoffs Mills.~ ?7375-8008 <br />PHOHE: 87~3~26 <br /> <br /> ITEM <br />BUILD~NG FEE <br />PLAN REVIEW <br />BUILDING STATE SURCHARGE <br /> <br />ARCHITECT/ENGINEER, <br /> <br />PHONE: <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUSRECEIPTS <br />THIS RECEIPT <br /> <br />BALANCE DUE <br /> <br />NO. <br /> <br />QUANTITY AMOUNT <br /> $56.58 <br /> <br /> $2.8~ <br /> <br />$96.06 <br /> $8.00 <br />$96.06 <br /> <br />$8.80 <br /> <br /> PAYEE: Slate & Slate Constrt~ction Inc 61853 <br /> RECEIVED BY: pm .................................. TYPE: IN CHECK ~: 0 <br /> <br />~ THIS ~S NOT A PERHIT. THIS APPLICAT/OH HUST GO THROUGH A REVIE~ PROCESS ~HERE THE <br />FOLLON[HG HUST BE COMPLETED., [T :~S THE RESPONS[BZLITY OF THE APPLICAHT TO ASSURE THAT <br /> <br />HEIGHT: SETBACKS: FR / <br />TOTAL S9 VT: 0 L,S'-/ <br />STORIES: RS-/ <br />PLAN.ACTION~ ER-/ <br />ENERGY PATH. SP~ .... <br /> <br />LL HECESSARY IHFORMAT[O~HAS BEEH PROVI])F~. <br /> <br /> ZONINg: BY . -?/ ' .... :' DATE-- .--'----~- <br /> SEPI'IC: BY ..... ~ZZl .... BATE ..... l---l--- <br /> CITY JURISDICTION: BY ........ DATE <br /> <br /> RENARKS: <br /> <br />REMOVE ROOFING, REPLACE W/CLAS8 A ROOFINg <br /> <br />OFF~CE COPY <br /> <br /> <br />