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MARION COUNTY BUILDING INSPECTION <br />SENATOB 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 a registered builder OR ( ) the authorized represer*taUve <br />o aeg s ered bu Ider, <br /> <br />.............. l -CO~iHl~ r<~IA ..... <br />WOON~¥~F~ TYP~: i OCCUPANCY' <br /> <br /> MARION CfUhlTYj NO ~ <br /> [ NO OF BEOAO0~S <br /> <br />' CZ1Y OR 9704~ SITE NUMBER-' <br />I PHOHE: 656-6819 ] VALUATION: <br /> <br /> WIDTH:- t~OEPTH; } A~:~ UNi~:~O ~ m~. LOT: ~CO ~, 4' <br /> <br />TYPE: BUILBIN6 <br /> <br />!] 0 I,I'F R A C T' ?.;:~: ,, HO.. <br />BEI.OT.F,F( E OOi..'TF;Y <br />PO '80X 3,':;0 <br />OREGON CITY OR 97¢J45.m <br />PHONE: 656-'6819 <br /> <br /> ITEM <br />BUILDING F'EE <br />Pl.,AN REVIEW :', <br />FIRE AND ,L..EPE S¢.FE'FY ~EV <br />BUILD1N(;- STATE StJR[';HARGI <br />ZONING SURCHARGE <br /> <br /> PAYEE: <br /> RECE[¥ED BY: PM <br /> * THIS IS HOT A PERM~'-- <br />F~LL~[NG M~ST ~E <br /> LL HEGESSRRY [NFORH~T~I <br /> <br />PERNIT OR APPLICATIOH HO: 9861842 <br /> ARCHTTECT/I=NGI,EE% NO. <br /> <br />PHONE: <br /> <br />$4S4.30 <br /> $0,,00 <br /> $0,.0~ <br /> <br />$434.30 <br /> <br />TYPE: CHECK $: 0 <br /> <br /> A REVIEW PROCESS WHERE THE <br />~HE ~PPLIC~HT TO ~S~URE THAT <br /> <br />PLAN REVIEW: BY SETBACKS: FR .......... <br />ZSi,IING:: BY ........ 0 LS <br />SEF T.[(,,, BY"' RR <br />(,, IY ,JU&:fJ;DI[YIIO Ir BY......,.:~ ...... ~J "'~% ......... :': ' / ' ......... <br /> ,~¢TE ~ E~GY PATH: SF'- ........ <br /> <br />REMARK D~;,t,-ME~A ~RHS/F;EED'NII_L E:~¢:~NSIOI~':::: <br /> OFFICE COPY Z/Iq/~ <br /> <br /> <br />