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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 PM - 8::00 A M <br /> <br />( <br /> I am performing work on a property I own or occupy <br /> I I am a rog~s~ered builder OR ( ~ the authorized representative <br />t <br /> <br />SIG NATLJR~ OF APPLICANT ........... <br /> <br /> DATE <br /> <br />owf~iTE: 07/24/89 TIME: 4:12:54m TA× LOT CATegORY <br /> sOOP,~J~, TOM 90040-020 <br /> <br />RESIDENTIAL. <br /> <br /> CONTRACTCIT¥ 5~ OCCU~NTLOA~--8 <br /> 925 9TH <br />AUMSVILLE OR 9?325 <br />USEOFBUiLD~NG AUMSVILLE NO NO OF~FDR©©MS <br /> <br />MAILINGAODRESS SINGLE FAMILY DWELLINGS <br /> <br /> PO 8OX 185 <br /> SUBLIMITY OR 97385 <br /> PHONE: 769-?364 <br />LOT BI.COP( <br /> <br /> DEL MAR <br /> <br />SITE NUMBER; 7698 <br />~,N~ALUATION:ZONe $39,~@0.00 <br /> <br />WIOTM 3 DGPTH ~. AREA 95 UNITS <br /> 74 110 <br /> <br />98 IRREG LOT 2W OOHNbH RS <br />SE YES NO <br /> <br />51 <br /> <br />TYPE: BUILDING <br /> <br />CONTRACTOR, NO. <br />TOM DORAN <br />PO BOX 185 <br />¢JUBLIMITY 97385 <br />PHONE: 769-?354 <br /> <br /> PERMIT OR APPLICATION NO: <br />58498 <br /> <br /> ITEM <br />BUILDING FEE <br />PLAN REVIEW <br />FLEET SURCHARGE -ZONE <br />BUILDING STATE SURCIqARGE <br /> <br />9017610 <br /> <br />ARCHITECT/ENGINEER, NO. MLILTI <br />MULTI/TECH <br />1155 13TH ST SE <br />SALEM OR 9?809 <br />PHONE: 968-922? <br /> <br />QUANTITY <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />AMOUNT <br /> ~238-00 <br /> 154.70 <br /> $3.84 <br /> $11_9o <br /> <br />$408-44 <br /> $0.00 <br />$408_44 <br /> <br />BALANCE DUE $0.00 <br /> <br />PAYEE: TOM DORAN ~' ~8714 <br />RECEIVED BY: PS - =~=~/~'~___m"Z:c_r~ 'FYPE: IN CHECK ~; 0 <br /> <br />· THiS IS NOT A PERMIT_ THIS APPLICATION MUST GO THROUGH A REVIEW PROCESS WHERE THE <br />FOLLOWING MUST BE COMPLETED. IT IS TtiE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT <br />ALL NECESSARY INFORMATION HAS BEEN PROVIDED. <br /> <br />SEPTIC~ BY ............. DATE <br />ZONING: BY ............ DATE ......... SETBACK2~: <br /> <br />REMARKS: NEW RES <br />HEIGHT: 14 TOTAL ~ FT: 1554 <br /> <br />CITY JURISDICTION= BY <br /> <br />DATE <br /> <br />PR-20 [S-5 RS-5 RR-5 <br /> <br />STORIE~; ~ PLAN.ACTION: <br /> <br />DORM f' MC 15-56 REV 11'88 OFFICE CO?Y <br /> <br /> <br />