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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 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am performing WOrk on aproperty I Own or occupy. <br />lamaregisteredbuilderOR{ )theauthodzedrepresentatlve <br />ol a registered builder, <br />The work will be performed by a registered builder, <br />Other, <br /> <br />OWNER'. <br /> £][] LiBLE,, ¥. t~ES ZDIZN]"i~ AL <br /> <br /> ~fl~ROl(¢~ 8R 97~t~2 ~I¢~RZCIN COIJi,ITY [i40 <br /> ! <br /> <br />YALUAT'," ON: <br /> <br />WIDTH; iDEP?H; ~ UNITS; ; IRREG. LOT: CORNER. <br /> <br /> TYPE: ~ECHANICAL PER~IT OR APPLICATION NO: <br /> CEIN'f·RAI'iTOF% NC.I,, 24844 <br /> H:f.d~sy Heal'i, nq Co <br /> <br /> t:'l f0NE ~ <br /> <br /> :I; PEM QUANTITY <br /> fl¢~S CONNE:C:TZBI4 <br /> <br /> H~:;[':I,IAI4:[6~I.. STAT[7 SIIRC;HARGF <br /> <br /> AMOUNT <br /> <br /> ¢22,, 85 <br /> '4;0 ,, 0;.~ <br /> $22,05 <br /> <br /> $0. <br />6 r,6 4 4',~ <br /> <br /> TOTAL AS, SES~ED <br /> <br /> R,:.[;I:,EVk, D [¢~ ~, ~ll.~ ' ', TYPE= CK Ciz:Ck <br />~ TH~:S ~S A VALI~ PERMIT ~ ~H~S PERMIT, EXPIRES 18~ ~AYS FROfl ITS ISSUE ~ATE. <br />bOflSTRUCTtON CEASES FOR A PERIOOfiOF 18~:DAYS, 'OR IF EONSTRUCTION FAILS TO ~EET ALL <br />EQUZREMENTS OF STATE LAWS AND M~EION COUNTY BUILDING AND ZONING ORDINANCES, <br /> ALL BECOME HULL AND VOID. · ' <br /> <br /> '~ f c', ,-,-, "," 3I]'[I_I~INI, ' ...... ' <br /> <br />FORM # MC 1~-56 REV, 4,~0 OF FIC E COPY <br /> <br /> <br />