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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-PRONE: 588-7904 <br /> <br /> I am performing work or~ a property I own or OOOUOy <br /> l am a regiStered builder OR ho au horzed epresena ye <br /> of a registered builder, <br /> The work will be performed by a registered builder. <br /> Other <br /> I I~ave road and agree to the teems stated on the reverse side of <br /> this document, <br /> DATE: 02/14/")4 TIME: <br /> <br />OWWER;BUINN; BOBBY <br /> <br />~ITUS ADDRESS: <br /> 8813 WEST STAYTON RD <br /> AUMSVILLE OR <br /> <br /> VALUATION: ' $17,280.00 <br /> <br /> i 2W EFU <br /> <br />OO~TR~OTOR. NO. RRCHITECT/ENCINEER. NO. <br />GUINN, BOBBY <br /> <br />..................... ~Ak' LOY ............................ ~I ........ ~O~NT I AL" <br /> ~s~ '~"-'i~ .............. aaOUFX.C,~ <br /> SE H-,l, <br /> 97325 i~A'l~h'Z4O~' ;~0'1~'¥ ¥'- ' ' ~'i OCCUPANT UOAD; ¢~ <br /> <br />PHONE: 859~2747 <br /> <br /> ITEM <br />BUILOING FEE <br />PLAN REVIEW <br />8UILDINQ STATE SURCHARGE <br />ZONING SURCHARGE <br /> <br />PHONE: <br /> <br />TOTAL ASSESSEO FEES <br />PREVIOUS RE'CEIPT8 <br />THIS RECEIPT <br /> DuE <br /> <br />QUANTITY AMOUNT <br /> $128.50 <br /> <br /> $6.43 <br /> <br />$224_8~ <br />224.89 <br /> $0.00 <br /> <br />PAYEE: <br />RECEIVED BY: DM2 0 <br /> <br />$0.00 <br /> <br /> - o~ ,"~:~rufl~lLZ/¥ UP THE APPLICANT TO ASSURE THAT <br />LL NECESSARy INFORNAT,.I~NDHA8 SEEN PROVIDED. <br /> <br />REMARKS. MAOHINE SHED <br /> <br />FORM ~ MC 15.56 REV'. 4,~0 OFFICE COPY <br /> <br /> <br />