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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HiGH STREET NE <br /> SALEM, OREGON 9'7301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br /> 24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am pePformmg work on a property I own or occupy. <br />I am a registered builder OR the authorized repfesentef ve SIGNATURE OF APPLICANT: <br />of a registered builder. <br />The work wile be performed bY a registered builder, <br />Other. <br />I have rDad and agree lo me terms statea on lne reverse 8ice ol DATE <br /> <br />ow~TE: 09/13/90 'ri~4E: ~ ;~: '19: 04 <br /> <br />SITUS ADDRE~~'I~P' OORTHY ~ E.~.RI. <br /> <br />11673 THRUSH CT NE <br />AURORA OR 97002 <br />USE OF BUILDING. ..... <br /> <br />CONTRACT CITY <br /> <br />rflAR iON COCNTY- <br /> <br />NO <br /> <br />MAILING ADDRESS' RELSIDEN'riAL ACC~RY STRLJc:ruRES SUBm~S~ON: <br /> <br />CENTURY <br /> <br />CATEGQRY: <br /> <br /> RE,~IDENI'IAL <br />OCCUPANCY: <br /> <br />OCCUPANT L~3 <br /> <br />PHCNE= <br /> <br />WJD+H: 22 DEPTH; <br /> <br />A,WEA ~ UNITS <br /> <br />SZTE NUIVlB ER: 10355 <br />~*~V~FUATim: zo~ $2' 200' 0q~^R' <br /> <br />~S RREG. LOT l~ CORNER <br /> <br />NO <br /> <br />TYPE: BUiLDiNG PERMIT OR APPLiCATiCf4 NO= <br /> <br />CONTRACTOR. NO. 64981 <br />PRESTIGE M081LE HONE SERVICE <br />8660 ~ CHEROKEE <br />TUALATiN. OREEtON 97062 <br />PHONE: 692-4256 <br /> <br />'fEN <br />BUILDING FEE <br /> RE¥ I E!4 <br /> <br /> 24604 <br />ARCHll'ECT/ENGINEER, NO. <br /> <br /> /- 93 :' .,:: :: <br /> eAL~IcE DUE <br />PAYEE: PR~'F[GE ~[LE <br /> <br />'rH[s [5 NOT A PE~JT - <br /> <br />QUANT 1 'fY <br /> <br />'f'YPEt RP <br /> <br />CHECK <br /> <br /> AMOUNT <br /> <br /> $0.0o <br /> <br />2881B <br /> 0 <br /> <br />REtcC, RFS: REFUND OF UN-IS.SUED APPLiCATiON <br /> <br />HEIG,',','H'r: TOTAL SO ?'r= <br /> <br />STORi~: <br /> <br />PLAN.ACTiON: <br /> <br />OFFICE COPY <br /> <br /> <br />