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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 8m performing wock on a property I own or OOOdpy <br />lamareBiStoredbuilderOR hca hoczed epesena ~e <br />SI a registered broider <br />The work will bo performed by a registered BuHdof <br />Othor <br />I have read 8nd agroe to the terms stated on the rocerse side of <br /> <br />fJAfE; 03/21/91 f~M~; 10:35:42 <br /> <br /> 5ENORN. BAri9 L. <br /> <br /> 190 3. FIFTH ST <br />AUMSVi LLb OR 9?325 <br /> <br />USE OF BUILDING <br /> <br />TAX LOT <br /> <br /> 5-N <br /> <br /> AUlvLSV~ LLE NO <br /> <br />RESi~)fF.-.NI IAL ACCESSORY S FRUCFURBSsuBDiViSlON <br /> <br />CATEGORY <br /> R~,SI DEN i iA <br /> <br />OCCUPANCY <br /> <br />OCCUPANT LOAD <br /> <br />p_rg. ~(.~X 4?3 <br />AUMSV l L L E <br />PHONE: 749-14,40 <br /> <br />LOT BLOCK SECTION TOWNSHIP <br /> 74 14 '/ <br /> <br />NUMBER: <br /> 1F,__5255 , <br />VALUAI ION: ..... $2'~ 592 .rJ0 <br /> <br /> YES NO <br /> <br />tYPE: 3LZI_OING PbRM[1 OR APPLiCAIiON NO: <br /> <br />C~N f RAC f OR. NO. <br />5ENORN, E)AViL) L,, <br />P.O. L40X 473 <br />AUM'.SV [ LLE <br />PHONE: 749,-1440 <br /> <br /> i f EM <br />BU I LI)LN61 PEk <br />PLAN Rk¥ i EW <br />UUiLOING 5fA fo SURCHARGE <br /> <br /> 90,~105b <br /> <br />, RCHI FECF/ENG.(NEE~, NO. <br /> <br /> IO'F'AL ~E~E0 FEES <br /> PRBVIOU$ RECEIPTS <br /> THiS RECEiPf <br /> <br /> BALANCE DUE <br /> <br />A,Y..P..E: ,mENORN. D~¢~].~L) L. <br />RECEIVED BY: PR ~F¢..~. 'IYPP2: iN <br /> <br />QUANII[Y <br /> <br />AMOUN¥ <br /> $38_5O <br /> $25,03 <br /> $~.9s <br /> <br />$0_00 <br /> <br /> 3279~ <br />CHECK ~: 0 <br /> <br /> ~:: IHi~ i$ NSf A PERf41I. 'THIS APPLiCAIiON FIUSI GO IHROUGH A REVIEWo'. ROCkNU' '" WHERE 1HE <br />P©LLOWiNG tvlUSf ~ COMPLEIEO. IT IS THE R~PONSiBILI'IY Off IHE APPLICANT ~O ASSURE YHAf <br />ALi_ NECESSARY iNPO?~VlAIiON HA~ BEEN PI'~OViDED. <br /> <br /> lNG: BY OAI E <br />REMARKS: R? STORAGE POLE <br /> <br />HEIGHI: TOIAL <br /> <br />CI'I'Y JURISDICIION: BY OAlk <br /> <br />SEIBACKS: PR 20 L5 5 <br /> <br />864~ 510RIES: 1 <br /> <br />R'-3 5 RR 5 SP <br /> PLAN.ACIION; <br /> <br />Mr5 15-58 REV 4/90 OFFICE COPY <br /> <br /> <br />