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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 RM - 8::00 A M <br /> <br />DATE~--doq~/~)3/-89 TIME: 8: 38: 24,~ <br /> <br /> 90040-230 <br /> <br />CONS T RUCTION TYPE 5~N <br /> <br />SITUS ADDR~¢~O 9TH <br />AUMSVI LLE OR 97325 <br /> <br />SINGLE FAMILY D~ELLING~ <br /> <br />SUBLIMITY OR 9?385 <br />PHONE: ?69-?364 <br /> <br />SITE NUMBER: <br /> VALUAT ION: <br /> <br />75 100 7500.00 SF NO NO <br /> <br />TYPE: BUILDING PERMIT OR APPLICATION NO; 9019225 <br /> <br /> RESIDENTIAL <br /> <br />R--~ <br /> <br />8509 <br /> $34,500.00 <br /> <br />CONTRACTOR, NO. 5549~ <br />TOM BOP. AN <br />PO BOX 185 <br />SUBLIMITY 9?385 <br />PHONE: 769-7364 <br /> <br /> I'rEM <br />BUILDING FEE <br />PLAN REVI EH <br />Ft. EET f:~URCHAR~E ~ZONE 3 <br />8UILDING STA'FE SURCHARGE <br /> <br />ARCHITECT/ENGINEER, NO. MULTI <br />MULTI/TECH <br />1~55 12TH ST SE <br />SALEM OR 97302 <br />PHONEt 369-9227 <br /> <br />TOTAL A~SESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />BALANCE DUE <br /> <br />QUANTITY <br /> <br />AMOUNT <br /> $215.50 <br /> $140.o8 <br /> $3.84 <br /> $10_78 <br /> <br />$370_20 <br /> $0.00 <br />$370.20 <br /> <br />$0.00 <br /> <br />PAYEE: T0¢4 DORAN .-¢/¢ 20493 <br />RECEIVED BY: ¢¢8 ~-¢/~_~ TYPE; IN CHECK ~; 0 <br /> <br />* THIS IS NOT A PERMIT. THIS APPLICATION MUST ¢O THROUE~t A REVIEW ~ROCESS ~-{ERE THE <br />FOLLOWING MUST BE COMPLETED. IT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT <br /> <br /> CITY JBRISDICTION: BY <br /> <br />SETBACKS: FR-20 LS-5 <br /> <br />1220 STORIES: 1 PLAN,ACTION: <br /> <br />DATE ........... <br /> <br />ALL NECES.~RY INFORMATION HAS BEEN PROVIDED. <br /> <br />PLAN REVIEW: ..... DATE- <br /> <br />SEPTIC; BY ............. DATE <br />ZONING: BY ......... DATE <br /> <br />RENARKS: NEVI RES <br />HEIP_.~IT: 14 TOTAL SO <br /> <br /> <br />