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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 />of a cegistered builder. <br />The work will be performed by a registered builder. <br />Other <br /> <br />gA ,:: .0//8/54 ]r.[h!.,, I1,,f4/,,45 <br /> <br />~i~-O~"ABA~'~'~' i:~'~':¢ ii;.[ : 66~S:r~UC¥10N TYPC; j <br /> : <br /> <br /> 6~5 81'H ST SE , <br /> <br />G~'['[~6'~8~'., ........ '~:-"F~H~g~-Ot~r :E'~ ~5~ ................................ ~5'~l~*~i~N; <br /> <br /> 2?45 LIE/ONNE [ AIhsVELLE <br /> <br />~'~; DE~N; A~¢: UNI~ i~G, LOT; <br />.............. -¢~:. ................ ~,:9--.j ......................... ~ ....................... <br /> <br /> TYPE: I)WELLIN6 PERHIT OR APPLICAT~OI~ <br /> <br /> .,OH IRACTOR~ ilO. <br /> John F Rieaer <br /> &~8 Rockl~dqe C~ NE <br /> <br /> :['1 EH <br /> <br /> ~)NELLING NECt"I~N Z 6~1_ <br />. ~WELI, IN6 ELECTRICAL <br /> 9~E LIi'6 s'r~'rE SURCI-I~RG~7 <br /> ~,LLI.INGA PLAN REVIEW <br /> <br /> 9~57892 BP <br />AREH:[ TECT/ENE]:NEER,~ l,lO,, <br /> <br />PHONE; <br /> <br />tOTAL: A~SEgSE~ FEES <br />PREVIOUS RECEIPTS <br />TH~S RECE:[PT <br /> <br />BALANCE DUE <br /> <br />(]UANTITY <br /> <br />AMOIJNT <br /> $250.24 <br /> <br /> $23.46 <br /> <br /> $656.87 <br /> <br /> --$74,,B9 <br /> <br /> 61045 <br />CHECK ~= <br /> <br /> ,.AA=E. John F <br /> RI!CEIVFP BY~ <br /> <br />FOLLO~[N6 HUoT ~E 6gHPLETED. '~T iS THE RESPOHS[~L~TY OF THE APPLICANT TO ~B~URE THaT <br />LL NECESSARY INF~R~ATION HAS BEEH PROVIDE~. <br /> <br /> , I..A I REV'[Et~'; BY DA~E~ HE'J:CHT= S~I';~ACKO: FR <br /> Z['IN;II,![,~ BY ............. ])~'lEt .............. , ........ TOTAL 9~ r.'T= 1&eS LS .......... <br /> <br /> : PLAN. ACTION~ RR ........ <br /> ENERGY PATH: SF' <br /> C.I l Y .JURIoI)]'[','f ION. BY DA'f E <br /> M,, ~,~K,?. S[:'[)/~¢IRi ...~tl~ -7~8.. ~ Sq ~T T8 ~E REPLACE9 Wt1685 SQ P'T'~ PAY HEM I%..AN R,.V.. J <br /> <br />OFFICE COPY <br /> <br /> <br />