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MARION COUNTY BUILDING INSPECTION <br /> SENATOR BLDG NO 225 <br /> , 220 HIGH STREET NE <br /> SALE~, OREGON 97301 <br /> <br /> PHONE 588-5147 <br /> CODE-A-PHONE 4::30 P,M, - 8::00 A,M,, <br /> <br />I am performing work on aproperty I own or occupy <br />am a registered builder OR <br />of a registered builder, <br />The work will be performed by a registered builder <br /> <br />J ha~e reed and agree to the terms stated on the reverse side of <br />thr~ document <br /> <br /> lr, N DE-~EN, H C)W~ F< D <br /> <br />DATE <br /> <br />TAX LOT CATBGORY <br /> <br /> SITUS ADDRESS CONSTRUCTION TYPE <br /> <br /> OR 9?342 CONTRACT CITY U~B <br /> DT <br /> <br />USE O~ BUILDING <br /> <br /> RESIDEN-rILL ACCES~RY ST~JCTURES <br />MAILING ADDRESS SUBDIVISION <br /> ~44~MON O <br /> <br /> ')UONE: 854-353; SITE IqdMBER: <br /> <br />OCCUPANCY <br /> <br />NO OF BEDROOMS <br /> <br />LOT BLOCK SECTION TOWNSHIP RANGE ZONE MAP <br /> "$ * 3 ~ ' 0 SE <br /> <br />Y','>C t]u ! L_O ! <br /> <br />CONTRACTOR, NO <br />~,q0E~'SFN, HOWARD <br /> <br />'~' ?NE S$4-3531 <br /> <br />~ERMIT OR SPPL!CATiON NO: ~0020~ <br /> ARCHiTECT/EiNG!NEER, NO <br /> <br /> I-FEN1 <br /> <br />cLt".F'f SLiRCHARGE -ZON~ ? <br />$ ~AT£- SLIRCHARGE <br /> <br />THiS RECEIPT <br /> <br />0LiANT~T¥ <br /> <br /> $0- O0 <br />$24 C4 <br /> <br />8ALAPCE DUE <br /> <br />:::'AYt;~] ANDERSLN, HON~RD INVOICE NO 2586 <br /> <br /> :c']ET./E0 BY: Df"' '~vpE: TN CHECK /~: <br /> <br />* T~IS IS NOT A PE~IT. ~IS APPLICATI~'~ST ~ ~ A R~IEN P~ ~ERE ~E <br />FOLL~ING ~ST BE ~PL~TEB. IT IS ~E RES~SIBtL!~ OF ~E APPLIC~T TO A%URE THAT <br />ALL NEC~ARY ZNFO~TZ~ HA~ 8E~ P~V~DED. <br /> <br />OFFICE COPY <br /> <br /> <br />