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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 />I am performing work on a property I own or occupy, <br />I am a registered builder OR the authorized representative <br /> <br />Other <br /> <br />this document· <br /> <br />SIGNATURE OF APPLICANT; ........ <br /> <br /> DATE: <br /> <br /> 0 DC, AN, <br />S~TUS AODR~SSI <br /> <br /> 870 8TH ST <br />A,~. v/,;~\/I L L ~ <br /> <br />9?325 <br /> <br /> TAX LOT: <br /> 90040-4,90 <br /> CONSTRUCTION TYPE; <br /> <br /> 8-N <br /> CONTRACT CITY; UGS; <br /> <br />AUtv~SV ! LLE NO <br /> <br />CATEGORY: <br /> !:~E!~; L%"."!',~ i :s~_ <br />OCCUPANCY: <br /> <br />OCCUPANT LOAO: <br /> <br />MAIUNGADDRESS: STNGLE FAMTLY DIAiELL. INGS <br /> <br /> SOX 185 <br />,S'JBLIMITY OR 973S5 <br />F~fiONE~ 769-7384 <br /> <br />SUBDIVISION: <br /> <br /> i,,3ELJVlAiT( '[ I I <br /> <br /> SiTE NUMBER: <br /> RAN~/ALUAT]ON: ZONE: <br /> <br />8335 <br /> $,~.>~.:8 .... <br /> <br /> DEP'FH: 8 AREA: 2~ UNITS: ~S iRREG. LOT: 2~/~ CORNER; <br />75 95 ? 125.00 SF <br /> <br />TYPE: ,,~ <br /> <br />PERMIT OR APPLICATIONN,..)": 9018785 <br /> <br />CONTRACTOR. NO. 55493 <br />TQ!v) E)O RAP,! <br />!:~O BOX !85 <br />SUBLlfv'.~ TY 97385 <br />RHONE; 769-?384 <br /> <br /> iTEf~ <br />BUILDING FEE <br />PLAN REVIEW <br />FLEET SURCHARGE -ZONE <br />SUIt_SING ST,~TE SLlrRCHARGE <br /> <br /> ARCHITECT/ENGINEER, ,0. I ...... <br />, ,qULT i/TECH <br /> ~155 73TH ST'SE <br /> SALEM OR o'~';,~. ~, ~ <br /> PHONE: 363-922? <br /> <br />Ot L&N T ': -FY .A!'~QU N T <br /> $" C. 3 ".': <br /> <br /> $ 363.83 <br /> <br /> So,cc <br /> <br /> ~ 9898 <br /> <br />[ EN PROCESS ~*t~'Er:',':~ '",-"* <br /> <br />TOTAL ASSES.SEE F~ES <br />OREVZ~'RECE'IqT~ <br />-HIS RECEIPT' <br /> <br />SALANCE"DUE <br /> <br />~:*,4y{'¢:, '"(wi /_I"J~:A'4 CONST <br />RECE.'VF:2 ~v: PE <br /> <br />'- ' ...... ~t..~S T <br />· ' ~..,._O~ NQ 8E <br />/~ .... N...,Eo_....R ;.~ FORtqA'7 ~ ON <br /> <br /> ~ ~, ~,,~ ,~ . ""}',',' ',,: ? ..... <br /> .... ~, ,~b BTM ........... ~ <br /> CITY JUR!SO[CT!OH: BV <br /> <br /> _F ~; BTM DATE <br /> <br />F, EN,~Ko N~ RES <br />"i~{~GH'T': ~4 TOTAL SQ'FT? "9320 ' STO~ES: ~ ~}%a.N.ACT~CN; <br /> <br />DATE <br /> <br />~o.~ ,~ MO ~s.se .Er ,/~ OFFICE COPY <br /> <br /> <br />