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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 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am performing WOrk On a property I own or occupy, <br />I am a registered builder OR the authorized representative <br /> of a registered builder, <br />The work will be performed by a registered builder. <br />Other <br /> <br /> OAT£: 07/10/90 <br />OWNER: <br /> GROF'f, VE~ <br /> <br />I'[ME: 11:40:32 <br /> <br />SITUS ADORESS: <br /> <br />SIGNATURE OF APPLICANT <br /> <br /> DATE: <br /> <br /> TAX LOT <br /> <br /> CONSTRUO¥1ON TYPE' <br /> <br />CATEGORY: <br /> <br /> 11723 NARBLER LANE NE <br />AURORA OR 97002 <br /> <br />USE OF BUI'~DING: <br /> <br />tqARiON CC/JNI'Y , NO <br /> <br />PRESTIGE I~H SERVICE <br />8660 f;~ CHEROKEE ST <br />PHONE: 692-4256 <br /> <br /> 9706;~ <br />FUALAT iN ,OR <br /> <br />LOT ' BLOCK: SECTION TOWNSHIP. <br /> <br />CENTURY MEA~ <br /> <br />~iI'E NUIV~ER: 10354 <br />VALUAT I ON: <br /> <br /> lW <br /> <br /> RREG. LOT CORNEB:. <br /> NO <br /> NO <br /> <br />RESIDENTIAL <br /> <br />OCCUPANT LOAD: <br /> <br />MAP: <br /> <br /> 1 <br /> <br />TYPE: NO81LE HO~IE PER~I'F OR APPLICAT[O~ NO: <br /> <br />CONTRA,C.'I'OR, NO. 64981 <br />PRF_~'rIGE I~OB[LE Hf.~E SERVICE <br />8660 E4~ CHEROKEE s'r <br />TUALATIN, OREGON 9?062 <br />PHONE: 692-4256 <br /> <br /> ITEJ~I <br />f~Ot~ILE Hf..~B BA~E FEE <br />tfl(~ILE H~E ~TATE FEE <br />~ILE H~E Z~iNG ~A~E <br />FLEET ~A~E -Z~E 6 <br />~ILE H~E ~TATE <br /> <br />PAYEE: <br /> <br />24598 <br /> <br />~XJP~T i l'Y <br /> <br />AMOUNT <br /> $89,25 <br /> 15. ?5 <br /> !5~25 <br /> ? - 69 <br /> 5.25 <br /> <br />TOTALA~SE,%~ED FEES $123.18 <br />PREVICUS RECEIPTS $123.18 <br />THiS RECEIPT $0.00 <br />BALANCE DUE $0.00 <br /> <br />RECEIPI' <br /> <br /> RECEIVED BY: pr2 ................... _'];_ .......................... 'rYPE., CHECK ~: 0 <br /> ~ THIS I~ A VALIO PF_I~IT ~ ~:::~ZS:pEI~II:T ~pJ~ 380 ~ F~ IT~ I~E ~TE. IF <br /> <br />~LL B~E <br /> <br />SETBACKS: FR 10 L~ 5 R~ 5 RR 0 SP <br />REC4ARKS: fvH PLACEf4ENT I~t3464 ............... <br /> <br />PLANNING ACTION: <br />6~NALD E. ~ODLE¥, fC~RION COUNTY BUILDING OFFiCiAL / BY <br /> <br />OFFICE COPY <br /> <br /> <br />