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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 perforr~mg work on a property I own or occupy <br /> lam a reg~sterod buifderORr bee o zed rep esen a ye <br /> of a reg~sfered bulldor <br /> The work will be performed by a rODiStered builder <br /> Other <br /> I na,e read and agree to the terms stated on the reverse side of <br /> <br />g)A f E,: 05/30/91 T [filE: <br /> <br />ADDRESS <br /> <br /> 11460 MCg;LBLLAN LANE <br />AUIv~SV I LLP OR 9?325 <br /> <br />USE OF' BUILDING <br /> <br />DATE <br /> <br /> TAX LOT CATEGORY I'~..~.~ <br /> CONSTRUCTION TYPE OCCLJPANCY <br /> <br />CONTRAC~ CITY USg OCCUPANT LOAD <br />MARiCN CfJXJN I Y NO <br /> <br />SUSDIVfSION <br /> <br /> PHONE: <br /> <br />LOT BLOCK SECTION TQWNBB IP <br /> <br />91]E NUMBER: <br /> VALUA f ;'ON; <br /> <br />RANGE <br /> <br />IRBES LO/ NO <br /> <br />ZONE <br /> <br />CORNE~c) <br /> <br />MAP <br /> <br />fYPE: RU, Jrff8 [NG <br /> <br />CON l RACIOR, NO, <br />BREBEE, EUGENE <br /> <br />P..~RMi [ OR APPLICAf,I, ON NOt <br /> <br />32570 <br /> <br /> itEM <br /> <br />PLUMBING SA,bE PB~ <br />PLU~31NG SfAfE ,~tJRCHARGE <br /> <br />PAYEE;: <br /> <br />QUAN¥iIY AMOUNf <br /> 4 <br /> $~o.0o <br /> <br />$58.80 <br /> $0_oo <br /> <br />BALANCE DUB $0.00 <br /> <br />RECEiPf NO: 34365 <br /> <br /> RECEIVED BY: ¢I FYPE: CA CHECK ~: 0 <br />* THiS IS A VALID PERI, iT * THiS PERI, IT EXPIRES 180 DAYS FROI~I iTS l..%~t.lE QATE. iF <br />C~,ISTRUCTION CEA~E~ FOR A PERIOD OF 180 DAYS, OR IF CONSTRUCTION FA[L~ TO REET ALL <br />RE(~JIRE'F, qf::~TS OF STATE LAIH~ AND I~ARiON COUNTY BUJLDIN~ AND ZONING ORDINANCES. THI~ PER/VlIT <br />SHALL BECOi~E NULLANO VOID. <br /> <br />REF4ARKS~ 4 FiX iN GARAGE <br /> <br />OONALD E, WOODL~Y, MARION COUN'IY BUILDING OFFICIAL / BY <br /> <br /> OFFICE COPY <br />FORM # MC 15-56 REV, 4/9o <br /> <br /> <br />