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MARION COUNTY BUILDING INSPECTION <br />coMMUNITY DEVELOPMENT CENTER <br /> <br /> ~5 Chumh St~t NE, Room 132 · biota, Or~ 97~01-3670 <br />Offloe Hour~: 8:00-4:~0 * Pho~: ~03) 58&~147 · 24-HR In--on Une: (~03) 373-4427 <br /> <br />;RO~S STRFET : Mill. CREKK RI) <br /> <br />F'ARCFI NIIMRFR :.. 56799-~01a PROPFR'FY LOgATOR: g81W30 <br /> PARCFI. S~TE : 5~.0,SF ZONE: I <br /> <br />f~WNFR NAMF : MJTCHFI[,MARK <br /> <br />APF'I.ICANT <br /> NAMF <br /> A~I)RFSS <br /> <br />PHONF <br /> <br />R~CK GOMFS <br />CAPITOL AWNTNG <br />P.O. B~X 47J4 <br />RAI.EM. fir <br />769-??44 <br /> <br />CONTRACTOR/ <br /> A~FNT <br />PHONE <br />7NRTALIFR <br /> PHflNF <br /> <br />CARVER ENTFRPRI.~ES IJiC <br />769-7744 <br /> <br />~23~0 <br /> <br />97~ <br /> <br />OCCB: 0898948 <br /> <br />MD LICENSE: <br /> <br />IJN)T 90 FT : <br /> <br />Fee <br /> <br />Oe~,:ri~tion <br />Manu~arturPd dww]lJMg fee 245. B8 <br />State ~urchar~e 12.25 <br />State ada~n:is~rative fee 20.08 <br /> <br /> A~sessed fees : 277.25 <br /> AdjustMants : <br /> Total fees : 277.25 <br />PAYFF: R)CK GOMFS Total payments: 277.25 <br /> ~alan~. due : .80 <br /> <br />~ ~l ~.. ~ IF J~TI~:-~B F~ A.~%~ ~ I~YS. OR IF <br /> <br />SIGNATURE OF APPLICANT: <br /> <br />Dr)NAIl) E WQO1)m. EY~ MARTllN COUNTY BUILI)TNG ()FFIC)A / BY MBOLL <br /> <br /> <br />