Laserfiche WebLink
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 />SIGNATURE OF APPLICANT: <br /> <br /> DATE: <br /> <br />ow~:FE,, 0g/9S/99 T'I~E: 10;3!:2Da <br /> <br />S~TUS ADD~ES;~A L. LS'r ROfVl, GARY <br /> <br />AUMeViL_E <br /> <br />OR 973~5 <br /> <br /> CONTRACT CiTy: <br /> <br />~ARION COUNTY <br /> <br />0AtEGORY: <br />OCCUPANCY: <br />OCCUPANT LOAD: <br /> <br />DENT I'A!, <br /> <br /> SAblE <br /> <br /> PHONE: "?~3'-,2 'i 3 ! SITE NUiv~JER; 8 <br />LOT SLOGK: SECTION: TOWnSHiP: ~A~G~"ALJAT TONi - zonE; <br /> <br />76,4 285 2 17740, SF NO N(3 <br /> <br />"lYrE; PLU!"48 N',IG <br /> <br />PERNII'T OR APPLICATION NO.: <br /> <br />CONTRACTOR, NO. 438,~,1 <br />BUDGET PLBG <br />'728 CL.AGGFTT ST NE <br />~{EIZER OR 97303 <br />;"'HONE: 3"7 ! "-'9300 <br /> <br /> ':. 'FEN <br />RESIDEN-f-IAL FTXTURE, ALTERATIONS <br />o,,,UN'8;NG ~ASE FEE <br />FLEE'r SURCHARGE '~'ZONE 3 <br />°LLI~B~NG STATE SURCHARGE <br /> <br />9019860 <br /> <br />Qu ,\.~1 T I I'Y AIvlOU N ? <br /> ,~,:,, ?0 <br /> <br />TOTAL ~SSE,S~ED FEES ¢81,54. <br />PREVIOUS RECEIPTE <br />TH,tS RECEIPT <br /> <br />~ALANCE DUE "~ O~ <br /> <br />PAYEE: WESTERN INTERIORS ~NC ~: /,¢/'J , RECEIPT NO: 19791 <br />RECEIVED 8v, ~8 ~ ',~: , TYPE' CK CHECK ~' 809 <br /> <br />* THIS IS NOT A PER24IT. THIS,APPLICA¥ION'Iv~JST,GO THROUGHA REVIEW PR~:)OES,~ ~,-tERE THE <br />FOLLCAIiNG NUST BE COf, IPLETED. IT IS THE'RESPOf~SIBILITYOF THE APPLICANT TO ASSURE THAT <br />ALL NECESSARY INFORMATION HA,~EEN PROVIDED. <br /> <br />r~: AN RfVI?~: BY ............. DATE '~?fvy ~ ~ T~,, 8v <br /> ...... ~L.R~DZCT~N ,_ ........ DATE <br /> <br />FORM ¢ MC 1B-56 ~(V 11/8" OFFICE COPY <br /> <br /> <br />