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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97'301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> of ~ registered builder, <br /> <br /> this document, <br /> <br />:'~JWf4~Aj'"' r :':< .................................................... TAX LOT; ~ CATEGORY'. <br /> <br /> ?; ;'< ~ C ~. ~:'?' '--- UGa; J OCCUPANT LOAD; <br /> ?'"'<' .... ~:'~0 <br /> USE OF BUILDING; NO OF ~EOROOMS <br /> <br /> CLESTER <br /> <br /> F:'H( <br /> <br /> TYPE: <br /> <br />CO,' t: <br /> <br />;~ ,] Sf,.,I,. , h[,.. <br /> <br />BUZL. D:N; FEL <br /> <br />BUILDING STATE SURCI,JARgE <br /> <br />$ :I, 7 8., ,5 ?.', <br /> <br /> $4 ,, :: :[ <br /> :/, E: ,, '5 3 <br /> <br />TOTAL A~.~ESSE. D FEi:.,:, $2'?,?.,,,v7 <br />FRI'-V.[ ],U~ RECEIPTS ' '~ ': "~' <br />TFII'S REIitE~F'T $8','J,/" <br /> <br /> BALANCE DUE ~,(' ,, <br /> F'AYk:E~, JUEDF_'N,~, X4Elr¢NAi:~D & DEBB]:E 6~7,.~4 <br /> <br />* THIS IS HOT A PER~IT. THIS A~LICATION MUST,'gO THROUGH A REVIEW PROCESS WHERE THE <br />FDI..LOk~ING MOS]- DE COMPLETED. ' IT i~ THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THaT <br /> EL HECESSARY ~HFOR~AT~ON HAS ~EEH PROVIDED. ' <br /> <br /> PLAN. ACT]:ON~ <br /> <br /> f.:'4/¢:~KS;; M)') a R2:~ODEL ZXZST:U~iG RES - <br /> <br /> OFFICE COPY <br />FORM # MC 1~.66 REV. <br /> <br /> <br />