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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SAL~jM, OREGON 97301 <br /> <br /> PHONE 588-5147 <br /> CODE-A-PHONE 4;30 P,M. r 8:00 A,M, <br /> <br />I am aregisterodbullderOR( }theauthorlzed representative <br /> <br />The work will be perforBned by a registered builder. <br />Other__ <br /> <br /> ...... ..,YL_OC ¢,, V~R,., <br /> <br />TAX LOT~ CATEGORY: <br /> <br />'R <br /> <br />SI'f'US <br /> <br /> 94. G'7 STAYTON ,:kr,') <br /> Ai :','ISV l L.L ~ <br /> <br />USE OF BUILDING: <br /> <br />MAIL~NG ADDRESS: <br /> <br /> SA~vlr,_-,' <br /> <br /> /-'HONE: ? (5 9--..8 '[ '~', '? <br /> <br />OR 97325 <br /> <br />,:~,NGLE , AM}'L, DNE~._..,h/,~o <br /> <br />WIDTH: DEPTH: <br /> <br />CONSTRUCTION TYPE: <br /> <br />SUODIVISION: <br /> <br />OCCUPANCY; <br /> <br />OCCUPANT LOAD: <br /> <br />N0. 0F BEDROOMS: <br /> <br />SITE NUMBER: <br /> VALUAT J OF,': <br /> <br />'TYPE= ~UiLDING <br /> <br />ERMi, 0~.. APPT_;:CAT!QN NO:: <br /> <br /> '1823 <br /> <br />.aRO,.~'r TzC"'/~Ix.:.,]NEE.. · u,, <br /> <br />769-838? <br /> <br />TOTAL ASSESSED FEES <br />PREVZOUS RECEIPTS <br />~'~,,,~ <br /> <br />3U,&NT ~ TV <br /> <br />PA ¥ E l.-'.: .,.N\,O z,~E <br />',?CF.,IVE'3 BY: 'DS 'rrPE: :HrffSK ~: <br /> <br />:~ ~IS IS A VALZO P~IT ~ %~IS PE~IT ~I~ 180 ~AYS F~ ITS I~E DATE. <br />~ST~CT~ C~ FOR A PERZOD 'OF 18.0 9AYS; OR, .ZF' ~ST~CTf~ FAI~ TO NEET ~LL <br /> <br />~ALL 8~E NULL ~D voiD. ., <br /> <br />OFFICE COPY <br /> <br /> <br />