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~ ~pl. R'cvd. DEPT. OF ~3UILDING INSPECTION Permit Number <br /> SR 3180 Center ~t.. N.E. ~.. ~ <br />8¥: ~ Salem, O~g~ 97~1 ~y: . <br /> .... R.H. WITHROW, BLD;* A~INi~RATOR <br /> <br />Bldg. Permlt:~ residen~ia~ .. Location Permit: <br /> <br />Owner; .... ~ Nolan Cottst. Corp. ,,. Phon-~:____~99--~319, Add~..~.. P.O., ,, <br /> <br />Bl~r, & No.: ~ same .oho~e:. , Addre~:~. <br /> <br /> Plans by; ....... ,~ame , Phone: Address: ....... <br /> <br /> I Zone (~hg, Part C~d. Use ' Varmn~ Fir ~u~ <br /> ~pp~ ~,e '" .... <br />29~8~1W ~ <br /> U~ ~ S~g,, ' Min R~. "Front' ~ :Sides <br /> <br /> .... sinqle ~,am~y reside~e <br /> <br /> ~ N~: 2~ ~[k, No: ,,, Wa~r Supply: , Dis~l: , , Study? <br /> <br />Subdv ......... Camei]ia. . Heights, I;1 __ Valuation; ~ 21~000D00 <br />Size of Lot: i~re~lar ,..Corner? ..... Permlt Fee: ~. $0 <br /> <br />Area of BId9: ... ]RSR ~o. ~t <br />No. of Stories' . <br /> <br /> shake <br />Type of Roof: ........... <br /> <br />PLans Chk. Fee: ............ <br /> <br /> 2.60 <br />State ~urcharge: . .- <br /> <br />Saptlc Permit Fee: , 25.00 <br /> 114.10 <br />Tot~ Fees: <br /> <br /> build aco~rdi~ to the ~4~b~lt~d PI~ and s~ffl~ti~s, ~e la~ of ~e ~ of Oran ~ ~e O~i~n~s of Mario¢ <br />~,GNATURE OF ~PLICANT; ~~/~~~ .~ ...~+. <br />VALi0ATIONS'~ .......... ~ L ~ ' ~' " ~ X '" <br /> <br /> ' REMAR~ / / r <br /> <br />PLEASE NOTE: Driveway and sidewalk in~eolJor~ are rectuired by..~blic Works: <br /> Other permits required by this dept; Plumbing L~ <br /> <br />58~-5036 <br /> <br /> <br />