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MARION COUNTY BUILDING INSPECTION <br /> SENATOR BLDG. NO. 225 <br /> 220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> CODE-A-PHONE 4:30 P.M, - 8;00 A.M. <br /> <br />I am performing work on a proBer[y I own or occupy. <br /> <br />The work will be oerformed by a registered builder <br />Other .... <br /> <br />,~ITLJS ADDRESS <br /> <br />4.07~ PI'PEF~ ,ST 'k~-'FT' CONTR,~OT CITY: UGB: OCCUPANT LOAD' <br /> ~XAR ION COUN T'r .... <br /> <br />5UNSE dAVE~ <br /> <br /> :," B '.,; B ~ AVE. <br /> ~O~EL.AND 2Al..;® <br /> <br /> VACUA -' <br />LOt BLOCK: SECTION; TOWNSHIP: RANGE ZQNE'. <br /> <br />'.,*~ GN-'-SII= SEWAG~ <br /> <br />CGN 7RACTOR~ NO, <br />',":!ON l S lO, 0CN <br /> AVE, RAtY,ADA <br />'-¥,;;IviEi~AND, CALI""' 9234.8 <br /> <br />90032'10 <br /> <br />wAT'E~ BUPRLY: CN <br />'EST 4OL. ES AEADY: <br />SITE EVALJATiON NUIvt8Ee. <br />EXZS~IN6 -ANK SiZe: <br />EXiSTiNG DRa. iN <br />GEPT;C -Ah, K PL/~PE©: 2187 <br /> <br />; TE~Vl ,* , '-; Tv , · <br /> ~,~U,AN r . .&,'xQUN r <br /> <br />AUTHORIZATION N,.~, .,,..E - FLD_ V[STT <br /> <br />~',V,,,Y~E: BiONiSIO, 0{A1 <br /> <br />* THIS IS NOT A PER, iT. THIS <br />FOLLQ~tNG ,~'UST BE COf4PL~TED. <br />,ALL NECES,_~RY INFOF~MATION <br /> <br />TOTAL A~ESSEG FEES <br />PREVIOUS RECEIPTS <br />THiS RECEIPT <br /> <br /> $0,00 <br /> $/~5.30 <br /> <br /> $ 3 ;_' C <br />JP:'3 <br /> <br />RB¥tEN . ROCSSS ~--;ERE THE <br /> APPLICANT TO ASSURE THAT <br /> <br />S Y :{ .A":' ~ <br /> <br />OFFICE COPY <br /> <br /> <br />