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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 P.M. - 8:00 A.M, <br /> <br />Other ........... <br /> <br /> PHONE: ?29-?384 ' SITE NUMBER: 5379 <br /> <br />LOT: : : : ; ] : ~ZO ': MAP ............ <br /> <br /> ' SF NO NC <br /> <br />TYPE: BUILDING PERMIT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO- 55493 <br />TOM DORAN <br />PO BOX 185 <br />SUBLIMITY 97385 <br />PHONE: 782~7384 <br /> <br /> ITDV~ <br />BUILDING FEE <br />PLAN REVID~ <br />FLEET SURCHARGE ~ZONE 3 <br />BUILDING STATE SURCHARGE <br /> <br /> 9010885 <br />ARCHITECT~ENGINEER, NO. <br /> <br />PHONE: <br /> <br />QUANTITY ,AMOUNT <br /> $208.50 <br /> 134.23 <br /> $3_ 84 <br /> $10.28 <br /> <br />TOTALASSEssED:::PEES $254.90 <br />PREVIOUS RECEIPTS:: $0.00 <br />W~'[S RECEIPT'' ~ $354.90 <br /> <br />PAYE : <br />RECEIVED BY: dm Z~' _ __~'J '_ : IN::::: CHECK ~: 0 <br /> <br />, OLL~Z~G ~UST 8E OO~PLETEO. ~ f8 ~H8 RES~S~{E:~,~; OF;,TH('~APEL~CANT ~0 ~RE THAT <br />ALL NECESSARY INFORMATfON <br /> <br />SEPTIC: BY .............. DATE <br />ZONING: BY DATE <br /> <br />RE~ARKS: NEW RES <br />HEIGHT; 14 TOTAL.. SQ <br /> <br />:: CI,~Y,Ju~'~SDZOtION: BY <br /> <br />1329 STORTES.: 1 PLAN.ACT[ON: <br /> <br />BATE <br /> <br /> <br />