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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 EM. - 8;00 A.M. <br /> <br />SIGNATURE OF APPLICANT: <br /> <br /> DATE: <br /> <br /> DATE: 0?/24/89 TIME.* 10.'56:11a <br />OWNER: TAX LOT'. <br /> <br /> ST MARYS PARISH <br /> <br /> 9168 SILVER FALLS HWY <br />AUMSVILLE OR <br /> <br />USE OF BUILDING~ <br /> <br />97325 <br /> <br />SE <br /> <br /> CONTRACT CITY: <br /> <br />MARION COUNT7 <br /> <br />MAILING ADDRESS: CHURCHES AND OTHER RELIGIOUS BUILDI.,LF~S~ON: <br /> <br />75300-270 <br /> NO <br /> <br /> CATEGORY: <br /> COI~'~1ERC I AL <br /> OCCUPANCY~ <br /> <br />OCCUPANT LOAD: <br /> <br />ED SHEEHAN <br />3896 CLOVERDALE DR SE TURNER 97392 <br />PHONE: 743-209? <br /> <br />LOT: BLOCK: SECTIONZ TOWNSHIP; <br /> <br /> 13 <br />W~DTH: DEPTH; AREA: UNITS; <br /> <br />88 <br /> <br /> SITE NUMBER: <br /> VALUAT I ON: <br />RANGE~ <br /> <br />IRREG LOT~ <br /> <br /> NO <br /> <br /> 2578 <br /> $t0,945.00 <br />ZONE: MAP: <br /> <br /> AR3 49 <br /> NO <br /> <br />TYPE: BUILDING PERMIT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. 43845 <br />BLAYLOCK ROOFING <br />9467 STAYTON RD SE <br />AUMSViLLE OR 97325 <br />PHONE: 769-6187 <br /> <br /> ITE~ <br />BUILDING FEE <br />PLAN REVIEW <br />FLEET SURCHARGE -ZONE 9 <br />BUILDING STATE SURCHARGE <br /> <br />PAYEE: <br /> <br /> 17507 <br />ARCHITECT/ENGINEER, NO+ <br /> <br />PHONE: <br /> <br />TOTAL A,?~ESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />BALANCE'DUE <br /> <br />QUANTITY <br /> <br />AMOUNT <br /> ~86.50 <br /> 56.23 <br /> $3.84 <br /> $4.33 <br /> <br />$150.90 <br />$150.90 <br /> $o.oo <br /> <br />$0.00 <br /> <br />RECEIVED BY: PS ...... TYPE: CHECK ~¢: <br />* THIS IS A VALID PER'FliT ~: ~'I$1PERM:IT EXPIRES 18,0 DA'CS FROM ITS ISSUE DATE. IF <br />CONSTRUCTION CEASES FOR A PEE;['OB4',,~)F ,180 ',DAYS. OR' 'f:F"COf~ISTR'~CTI.,O~. FAILS TO MEET ALL <br />REOUIREHENTS OF STATE LA[,~ AND'..f4AR]('ON OOUNTY'BUILDING AND"ZONING ORDINANCES THIS PERMIT <br />SHALL BECOt4E NULL AND VOID.. ..... . . . . ... <br /> <br />SETBACKS= FR- LS- RS-- RR-~___ SP~ .... <br /> <br /> DONALD E. NOODLEY, MARION COUNTY BUILDING OFFICIAL / BY <br /> <br /> OFFICE C, OPY <br />FORM # MC 15-56 REV ~1/88 <br /> <br /> <br />