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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM,- OREO'ON 97301 <br /> <br /> PHONE 588-5147 <br /> CODE-A-PHONE 4:30 ~5. M. - 8:00 A.M, <br /> <br /> I am performing work on a property I own or occupy. <br /> <br />OATE: 09/30/87 TIME: 4:34:45p <br /> <br /> JOHNSON, ACE <br /> <br /> 401 CLOVER ST <br />AUMSVILLE OR <br /> <br />SIGNATURE OF APPLICANT: <br /> DATE: <br /> <br />fAX 'LO¥: <br /> <br />CONSTRU6+~6N ~'rFe <br /> 5N <br />CONTRACT C~T¥: i Li~N: <br /> <br />AuMSVILLE f NO ' <br /> <br /> RESIDENTIAL <br />, OCCUPANCY:~? <br /> <br /> RESIDENTIALACCESSORN'.S~RUCTURES ..... <br /> <br />7055 N 3RD ST <br />TURNER 9?392 <br />PHONE: 743-43?? i SZTE NUMBER: 2585 <br /> <br />LOT: BLOCK: ;SECT ON <br /> <br /> VALUAT T ON: $4,500.00 <br />if6wN~RM . RANGEi : ~SN~: MAP: <br /> <br />WIDTH: DEPTH: <br /> <br />AREA: J UN'TS: IRREO, LOT; CORNER: <br /> i NO ~ NO <br /> <br />TYPE: BUILDING <br /> <br />CONTRACTOR, NO. <br />JOHNSON, ACE <br />7055 N 3RD S'T <br />TURNER 97392 <br />PHONE: 743-437? <br /> <br />PERMIT OR APPLICATION NO: 9004713 <br /> <br /> ARCHITECT/ENGINEER, NO. <br /> <br /> ITEM <br />BUILDING FEE <br />PLAN REVIEW <br />FLEET SURCHARGE '~ZONE 3 <br />SUILDZNG STATE SURCHARGE <br /> <br />PAYEE: JOHNSON, ACE <br /> <br />PHONE; <br /> <br />QUANTITY <br /> <br /> ¢OTAL ASSESSED FEES <br /> PREVIOUS RECEIPTS <br /> THIS;RECEIPT <br />BALt~cE DUE <br /> <br />A~OUNT' <br /> <br /> S2.8~ <br /> $3,84 <br /> $2,53 <br /> <br /> $0.00 <br />$89_7o <br /> <br />$0.00 <br /> <br />527! <br /> <br />T THIS IS NOT A PERMIT. ~IS A R~I~ p~c~s ~E THE <br />FOLLOWING MUST BE COMPLETEO.~ IT ;IS THE R~SIB;ILI~%Y OF:THE;APPLICANT TO ASSURE THAT <br />ALL NBCESSARY ;NFOR~AT~ON H~ '~ P~MZD~D~ ' <br /> <br />PLAN REVIEW: B~ <br />SEPTIC¢ BY <br /> <br />ZONING: BY ......... DATE ......... SETBACKS: ER-20 LS-5 <br /> <br />REMARKS= STGESHED <br />HEIGHT: 17 TOTAL SO FT: ¢2¢'~:~'"'0 sToRIES: <br /> <br /> ::.CITY JuRIBDIOTrON: BY ......... DATE .......... <br />DATE ~ <br /> <br />PLAN.ACTION: <br /> <br /> <br />