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MARION COUN'FY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> <br /> 285 Church Street NE * Room 132 · Salem, Oregon 97301-3670 <br />Office Hours: 8:00-4:30 · Phone: (503) 588-5147 · 24-HR Inepoctlon Line: (503) 373-4427 <br /> <br />VAI.UATION : $2~S. R0 <br /> <br />WORK DFSC :COVFRFD WALK FROH HO[I~E Tn CARPORT <br /> <br />CITY= HARION COUNTY <br /> <br />1J377 SHAFF RD SF AH <br /> <br />CR~SS STREET = RAINWATER <br /> <br />PARCEl NIINRFR g 60543-eB~ PROPFRTY LOCATOR= BglWBS O~I~B <br /> PARCEl, SIZE = t.5~ AC ZONE= EFU <br /> <br />OWflFR NAHF' : RAYtISS, HORACF C &VTRGTNIA C <br /> <br />APPI.TCANT <br /> HAME <br /> ADDRESS <br /> <br />PH~NF <br /> <br />: RAYLTSS, HORACF C &VTRGINTA C <br /> STAYTON, OR <br /> <br />CONTRACTOR/ : <br />A~FHT : RAYLT~S~HORACE C & V~R~TN~A C <br />PHOHE <br /> <br />OCC~: <br /> <br />RIITLPTNG SO FT: <br /> <br />STORTFS: 1 HEIGHT: <br /> <br />Units Description Fee <br /> <br /> t.~ PI~n Re¥ie~ Fee 2[.~3 <br /> I State surcharge 1.63 <br /> 1 ~on~ surcharge 1.63 <br /> <br />Assessed fees : 56.89 <br />Adjustments ~ .~ <br />Total fees : 56.8? <br />PAYEE= BAYI.ISS,HORACE C b VIRGINIA C Total payments: 56.69 <br />Balance due: .B9 <br /> <br />THIS PFRtIIT lit )I01f-TRNiSFERABLE NID EXPIRES 188 DRYS FRO# Ili~ Mll[ IF WORK <br />I~ NOT C~, OR IF C~RUCTION CEASES ~ A PERIOD OF limb DAY~, OR IF I~ORK <br />F~ILS TO HEFT t&L R~GUIREItENTS OF STATE L~k~ ~ HARION COU~ ORDIN~. UPO~ <br />i~RITTF.~ REGU~.gT~ ONE SIX HONTH EXTFJ~ION HAY I~ gR~ITE~. <br /> <br />SI(*;NATURF OF APPLICANT= ..................................... <br /> <br />flONAI )~ F WtqODI FY~ MARION COUNTY BUILDING OFFICIAl / BY MBULL <br /> <br /> <br />