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MARION COUN BUILDING INSPECTION <br /> <br /> 3150 Lancaster Dr. N.E. · Suite C · Salem, Oregon 97305-1398 <br />Office Hours: 8:00-4:30 · Phone: (503) 588-5147 · 24-HR Inspection Line: (503) 373-4427 <br /> <br />WORK 5FRE ..... 7-RFR~EC-CARACF-TO-RF~RF;T;ORAE-RO~R-ERF-9?c~F2;BEOE~TOR;-~82925~0040~ <br />BITE A~RESS : CITY: AUFlSVILLE <br /> 775 OINEY ST AM <br /> <br />SIJBOIVTSION : LOT: BLOCK: <br />TAX ACCOUNT : 57799-888 HAP: 51 ZONE: RS LAND USE: <br />PARCEl_ SIZE : 88~.S~ SF <br /> <br />APPLICANT <br /> : L~TTAU~JOYCF HAXINE OWNER: LITTAU~JOYCE HAX[NE <br />ADDRESS : P 0 SOX 1023 CONTR: LITTAU~JOYCE MAXINE <br /> AUMSVIL[.F, OR OCCB: <br /> <br /> PHONE : <br /> <br /> TOTAL SO FEET : 1ST FLR: ~ND FLR: 3RD FLR: <br />· GARAGE: BASENENT: OTHER: <br /> VAI.UATIOH : $5~B~.~ STORIES: I HEIGHT: <br /> <br />IJni~ ~escr~pt~on Fee <br /> Building Fee 50.50 <br /> 1.S Plan Review Fee 32.83 <br /> I Investigation Fee 58.50 <br /> 1 State surcharge <br /> <br /> Assessed fees : 136.36 <br /> Adjustments : .~0 <br /> Total fees : 136.~6 <br /> PAYF'F: LITTAU~JOYCE MAXINE Total payments: 136.36 <br /> Balance due: .SS <br /> __TH.~9 PERMIT IS NON-TRANSFERABLE 41~ EXPII~S 18~ D~YS FROH ISSUED DATE IF I~ORK <br />~'~r ~ ......~F Z NOT ~B, ~ IF COflSTRUCTIGH CEASES FOR R PERIOD'OF 18~ DRYSs Ol~ IF IJORK <br />........ ~ LG TO flEET ~a.L REGUIREflEHTS OF STATE I~at8 N4~ IMRION C:(XJNTY ORGIHAHCES. UPOH <br />i~ .- ' IJRITTEH REllUEBTs OHE SIX Ill]NTH EXTEI48ZOH IMY BE gI~HTED. <br /> <br />[ ] I am the PROPERTY OWNER and own, reside in~ or will reside in the completed <br /> structure and will be my own general contractor. I understand that I must <br /> register as a construction contractor if the structure is sold or offered for <br /> sase before or upon completion. If I hire subcontractors. I will hire only sub- <br /> contractors registered with the Construction Contractors Board. If I change my <br /> mind and do hire a general contractor who is registered, I will immediately <br /> notify Marion County of the name of the contractor. <br /> ] I am the CONTRACTOR registered with the State of Oregon. <br />[ ] I am an AUTHORIZED REPRESENTATIVE of the property owner or contractor. <br />SIGNATURE OF APPLICANT: ~ <br />OONAt~ E WDODLEY, MARION COUNTY BUILDING OFFICIAL / BY PNUHRO~I/ <br /> [- <br /> <br /> <br />