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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 688-5147 <br /> CODE-A-PHONE 4:30 P,M, - 8:00 A.M, <br /> <br /> I am performin9 work on a property I own or m¢oupy, <br /> I 8f?l a registered builder OR ( ) the authorized representative SIGNATURE OF APPLICANT: ' <br /> <br /> DATE~ 05/~4/88 TI~E: ~: 11 <br /> <br />OWNER: RINNER, JACOB g. =*x Ce~: lS~b4~ ~CA~GO,Y; RESIDENTIAL <br /> <br /> 150 <br /> ~E <br /> DET~IT OR 9?342 CONTRAOT CITY: ; g : ~dS~u~NT LOAD; <br /> DET~ZT NO <br /> <br />USE OF BUILDING <br /> O~ER N~-R~[D~T[AL BU[LD[N~ <br />MA~UNe A~D"~SS: ,suemw~°~ ~OKEY CREEK <br /> ~ BOX 54? <br /> DET~ZT, ORE 97342 <br /> ~E= 854¢3443 S[TE NU~ER: 45~1 <br /> VALUAT [~: $3,244,80 <br /> <br />LO'~: 6 8 1 ' 10 : ' 5E : ' <br /> <br />TYPEs BUILDING PERNIT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. <br />RINNER, JACOB L, <br />PO BOX 547 <br />DETROIT, ORE 9?342 <br />PHONE~ 854~$443 <br /> <br /> ITEM <br />BUILDING FEE <br />PLAN REVIEW <br />FLEET SURCHARGE -ZONE ? <br />BUILDING STATE ,~UR(IHARGE <br /> <br />PAYEE: RINNER, JACO8 L+ <br /> <br /> 9008?20 <br />ARCHITECT/ENGINEER, NO. <br /> <br />QUANTITY <br /> <br />Aj'V~UNT <br /> $44.50 <br /> $28.93 <br /> $8.96 <br /> $2.23 <br /> <br />TOTAL ,,NssESS£D FEES $84.62 <br />PREVIOUS RECEIPTS $0.00 <br />THIS RECEIPT $84.62 <br /> <br />BALANCE EXJE $0.00 <br /> <br />g354 <br /> <br />RECEIVED BY: Df4 :TYPE: IN CHECK ~¢: 0 <br /> <br />~ THIS IS NOT A PERNIIT. THIS APPLICATION MUST: GO THROUGH A: REVIEN PROC~ INHERE THE <br />FOLLOi, VING NUST BE COMPLETED. TT ISTHE RESPONSIBILITY:OF THE APPLICANT TO A,SSURE THAT <br /> <br />ALL NECESSARY iNFORM4/TION HAS BEEN PROVIDED,: <br /> <br />SEPTIC: BY ...... DATE ...... <br />ZONING: BY ....... DATE ......... S~BACKS: FR-20 ES-5 <br /> <br />R~ARI~: ~VERING OVER ~ILE HOME ' <br />HEIGHT: TOTAL ~Q FT: 1248 STORIES: 1 <br /> <br />CITY JURISDICT[~: BY ....... ~TE ......... <br /> <br /> ~.~-5 R~5 S~0 <br /> PLAN.ACTION: <br /> <br />¢o~ ~¢ ~c ~5.~ ~6v ¢m¢ OFFICE COPY <br /> <br /> <br />