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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 />lamaregistoredbuilder OR( } the authorized representatwe <br />of a registered builder <br />The work will be performed by a registered builder <br />Other <br /> <br />SIGNATURE OF APPLICANT <br /> DATE <br /> <br />°W~SA~I' E: 10/31/90 f Jt4E: <br /> <br />SITUS *DDRE~IARIIBAY, JEISUS <br /> <br />TAX LO~ CATEGORY <br />CONSTRUCTION TYPE OCCUPANCY <br /> <br />RESi DEN fiAL <br /> <br />?00 ll'FH SI <br /> <br /> R~ I D ~-l~l 1 <br /> <br /> 4395 GARY Sf <br /> Kc-J. ZER. OR 9?303 <br /> PHONE: 390-2267 <br />LOT BLOCK <br /> <br />SECTION TOWNSHIP <br /> <br />NO NO or <br /> <br /> EVER6RE~=J~ lviOM1Lb HOME PARK <br /> <br />Si1E NURSER: 11614 <br />RA~,"C~LUA l IC~: ZONE $600.0~*~ <br /> <br />IYPEz 8UiLOiNG PERt411 OR APPLICATION NO: <br /> <br />CONIRACFOR, NO. 14922 <br />CENTRAL ORF..EYJN t,lOStLE <br />285 ~.PAC~F]C HJSHWAY <br />~U~, OREG~ 97071 <br />~ONE: 981-3141 <br /> <br />BUILDING FEE <br />PLAN R~V i EW <br />FL,F. EI SURCHARGE -ZONE :¢ <br />BUILOiNG STARE SURCHARGE <br /> <br />PAYEE: ¢¢ARIBAY, JESUS <br /> <br /> 90284.4? <br /> <br />ARCHI 1 ECl/ENGfNEER, NO. <br /> <br />IOTAL ASS~ED F'EE~ <br />PREVIOUS RECEIPTS <br />THIS RECEtPT <br /> <br />QUANIiIY <br /> <br />AIv~,,IJNI <br /> $10.00 <br /> <br /> 3.84 <br /> $o.~o <br /> <br /> $o.9o <br />$20.84 <br /> <br />BALANCE DUE $0.00 <br /> <br />~0052 <br /> <br /> RECEIVED BY.' PR fYPE: IN CHECK ~: 0 <br /> <br />*rH[S [S NOI A PER~I[r. 'rHi~4 APPL[CAT[ON HU~T ~ TH~G~ A RE. ZEN P~ ~HgRE THE <br />FOLL~1NG ~f BE ~PLETEO. ['l[S THE R~S[B~L[f'Y OF THE APPLJ~I ]O A~RE /friAr <br />ALL NEC~ARY [NFO~r[ON <br /> <br /> BY~_ DATE//.%~. ¢~ C~rY JURISDICrION: BY DAlE <br /> PLAN <br /> R~ViEW: <br /> <br /> 5EP~ iC: <br /> <br />ZONING: MY DAlE ~ETBACKS: FR 15 LS 10 RS 10 RR 0 SP <br />REMARKS: CAR~R~ <br /> <br />HgiGHf ~ ,~ ]OIAL S(~ 0 SIORIES: PLAN.ACI iON: <br /> <br />OFFICE COPY <br /> <br /> <br />