Laserfiche WebLink
MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NC) 225 <br />220 HIG, M STREET NE <br /> SALEM, OREGO.N ~7301 <br /> <br /> PHONE 588-5147 <br /> CODE-A-PHONE 4;:30 PM - 8::00 AM <br /> <br /> I am performing work or~ a property I own or occupy <br /> lamareglsteredbuilderOR( )theauthorizodrepresentatwe <br /> of a registered builder <br /> The ~ork wUI be performed by a registered builder <br /> Other ..... <br /> I have read and agree to the terms stated on the reverse side of <br /> th~8 document <br /> <br /> DATE: 06/09/8? TIME: 3:24:86p <br />OWNER <br /> CfTY OF AUMSVlLLE <br />SITUS ADDRESS <br /> <br /> 1200 WAIN ST <br />ALIMSV I LLE OR 9?325 <br /> <br />USE OF BUILDING <br /> <br />SIGNATURE OF AppLICANT <br /> DATE <br /> <br />TAX LOT CATEGORY <br /> C <br /> <br />CONSTRUCTION TY P~E OCCUPANC ¢ <br /> L/./ <br />CONTRACT CITY UGS OCCUPANT LOAD <br /> <br />NO OF BED~00M5 <br /> <br />PO BOX 22? <br />AUMSVILL. E OR 9?325 <br />PHONE: <br /> <br />LOT BLOCK SECTION TOWNSHIP <br /> <br />SITE NUMBER: 1613 <br />VALUATION: $1,6?2.00 <br /> <br />TYPE; @UILDING PERMIT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. 31891 <br />OSSENKOP CONSTRUCTION <br />1255 BOONE RD SE APT 56 <br />SALET4 OR 9?309 <br />PHONE: 581--7122 <br /> <br /> ITEM <br />BUILDING FEE <br />PLAN REVIEW <br />PLEET SURCHARGE -ZONE 3 <br />STATE ,SURCHARGE <br />ZONING SURCHARGE <br /> <br />PAYEE: OSSENKOP CONSTRUCTION <br /> <br /> 9002618 <br /> <br />ARCHITECT/ENGINEER, NO. JMS ENGIN <br /> <br />¢HONE; <br /> <br />TOTAL 4,SSBSSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />QUANTITY <br /> <br />ANOUNT <br /> $28.00 <br /> $18.20 <br /> <br /> 1.12 <br /> 1_40 <br /> <br />$52,55 <br /> $o.0o <br />$52.56 <br /> <br />BALANCE DUE $0.00 <br /> <br />INVOICE NO: 3121 <br /> <br />RECEIVE0 BY: cm ................ ~ TYPE: IN CHECK ~: <br />~ THIS i$ NOT A PERNIT. THIS APPLICATION NUST 'GO T~RC~JGH A R~I~ P~ ~ERE ~E <br />~L~ING ~T 8E ~ED+ IT IS ~E R~SIBI'LI~ OF ~E APPLI~T TO ~RE ~T <br />ALL NEC~ ZNFO~TZ~ H~ BE~ P~ZDED. <br />PL~ REV lEN: 8Y~ BATE_~¢//'~ , ' <br /> CZTY JUR[SD~OT[ON: BY ........ DATE <br /> <br />SEPTIC: 8Y ................. DATE <br />ZONING: BY~g~F DATE~ SET~¢KSf?~ LS- RS- RR- <br />RE~R~S, PICNIC ~ELTER ~MIgL CR~E~A~'~ <br /> + <br />HEIGHT: TOTAL ~ FT. ~/~ 0 STOR%ES,: : P~NING ACTION: <br /> <br />OFFICE COPY <br /> <br /> <br />