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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO, 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> " PHONE 588-5147 <br /> CODE-A-PHONE 4:30 P.M. - 8:00 A.M. <br /> <br />i'~m performing work on a groperty I own or occupy, , <br />I am a registered builder OR ( ) the authorized representative <br />of a registered builder. <br />The work Will be performed by e registered builder, <br />Other_ <br /> <br /> DATE: 0,~/24/87 TIME; 3:01:31p <br /> <br />OWNER; <br /> 8ERGERSON, ROGER M & PAULINE C <br /> <br />SITUS ADDRESS; <br /> <br /> 9833 N, STAYTC)N RD SE <br />AU~SVI LLE OR 9?325 <br /> <br />use OF BUILDIN(~: <br /> <br />PATE; <br /> <br />, TAX LOT; <br /> 61352-000 <br /> <br />CONSTRUCTION ~¥P~: <br /> 5N <br />· CONTR~ ~i~Y'. , UBB'. <br /> <br /> RESIDE~XIALACCE~YSTRUG%URES , <br /> <br />SAME <br /> <br />PHONE= 749-,2561 <br /> <br />LOT: SLOOK; <br /> <br />TYPE: BUILDING <br /> <br /> VALUATION~ <br /> <br /> SECTION: !tOWNSHiP; RANGE~ ZONE; <br /> 9S <br /> <br />PEPJVllT OR APPLICATION NOs . 1647 <br /> <br />C~NTRACTOR, NO, <br />8ERGERSON, ROGER ~ & PAULINE C <br />SAME <br /> <br />PHONE: 749-25~ 1 <br /> <br /> ITEM <br />IBUILOING FEE <br />PLAN REVIE~ <br />¢'LEET S.,URCHARGE -ZONE 3 <br />STATE SURCHARGE <br />ZONING SURCHARGE <br /> <br />ARCHITECT/ENGINEER. NO_ <br /> <br />QUANTITY <br /> <br />PAYEE: <br />RECEIVED BY: P8 <br /> <br />$ THIS I$ A VALID PER~IT $ TH] <br />CCNSTR~CTION CE~ASE, S FOR A PERIl <br />REqUIRE~IENTS OF STAT~ LAWS $ <br />SHALL BECOME NULL AND VOID. <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />BALANCE DUE <br /> <br />OCCUPANT LOAD~ <br /> <br />EFU 62 <br />N <br /> <br />INVOICE NO: <br />CHECK <br /> <br />FROM ITS ISSUE DATE. IF <br /> FAIL...~ TO MEET ALL <br /> <br />AMOUNT <br /> $68_50 <br /> $44.53 <br /> ~3.84 <br /> 2,74 <br /> $3.43 <br /> <br />~123,0d <br />~23_04 <br /> $o.oo <br /> <br />$0.00 <br /> <br />ORDINANCES, THIS PEF~IIT <br /> <br />SETBACKS=FR-~0 LS-IO <br /> <br />RENARKS: CARPORT CROSSES <br />HEIGHT .* TOTAL <br />DONALD E, WOODLEY, <br /> <br />OFFICE COPY <br /> <br /> <br />