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s, uuN I Y UUILDING INSPECTION <br />COMMUNITY DEVELOPMENT CENTER <br /> <br /> 285 ChMreh Street NE · ROOm 132 ,, Salem, Or.Ion 97301-3670 <br />Office Houra: 8:00-4:30 · Phone: (503) 588-5147 · 24-HR Inepe=tion Line: (503) 373-4427 <br /> <br />(::ROSS STRFFT : ])FI HAR DR]'VE TO 4TH ST TO H:TCHAFI WAY <br />PARCFI. NLIHTIER : 57779-R87 <br /> <br />I~R NAH£ <br /> <br />APPI. TCAHT <br /> HAHF <br /> AO~)RE.~S <br /> <br /> PHI*JK~: <br /> <br />~flNI'RA~TOR <br />PHONF. <br /> <br /> FCTRZ~:TAN <br /> PHON~. <br /> <br />SIIPV FI FC <br />PHONE <br /> <br /> = WFEgE, KFNNFTH R <br /> <br /> ~ HF EIF~TR~C ~N~ <br /> 1557~ MAY RD <br /> <br /> DAI[A~q. OR <br /> : ~3-49~7 <br />~ HF FLFCTR~C <br />: 6~3-4967 <br />= H.F~ EIFCTR~CAI <br /> <br />= FVAN8 HTCHAEI A <br />= ~VANS HTCHA~t. A <br /> <br />9733~ <br /> <br /> OCCB= E~77014 <br />CONTRACTOR LICENSEI 27-5eC <br />SIIPFRV)SOR LICENSE= 37~8S <br /> <br />~~;_~.~ ~p~o ~.. ~.p~i--------- Fee . <br />Sta~e surcharge le.~ <br />Refund <br /> 3.0~ <br /> <br /> Assessed fees : 63. B~ <br /> AdJtastnents ~ .~ <br />PAYFF~ MF £1FCTRTC ~N~ Tota! fee~ ~ <br /> <br /> Total pay~ents~ 63.99 <br /> <br /> , TX ~ ~NSZ~ ~y ~. ~ ~Y ~8. ~ <br />~TGNATIJR~ OF APPI.TCAHT: <br /> <br /> .... ~ .n .UIJ~/T UUtI.DTH~ OFFTC~AL / BY DSTON~ ~ <br /> <br /> <br />