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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 />J am performing work cA a property I own Or occupy. <br />l am a registered builder OR ( )theaut~orizedrepfesentative <br />ol a regf~tered builder. <br />The work wHI be performed bY a deOistered builder. <br />Other <br /> <br /> ~,45 A'IAiN ST <br />Aur4Svi LLE <br /> <br />USE OF BUILDING: <br /> <br /> I have read and agree to the terms stated on the reverse side of <br /> this document, <br /> <br /> DATE; 04/03/91 l'irflE: 11 <br />OWNER[ TAX ~.OT; CATEGORY <br /> 8RADLEW, KELLY 90080-430 <br /> <br /> OR 97325 i . ~ ; <br /> ~VILLE <br /> <br />1550 ]'Uf4A, LO DR SE <br />PHONE: 749-~8~4 <br /> <br />LOT: <br /> <br />5/6 <br /> <br /> I~ERRI P'~ ELr.)S ADDI 'f' J[ON <br /> <br />SITE NUfflBER: 12638 <br />VALUAT iON; $?, 500. O0 <br /> <br />2W i C <br />I~EG LOT: NO ~CO.NER~ <br /> <br />CON~ERC i AL <br /> <br />'fYPE: BUIL0[NG PER~i'r OR APPLICATION NO: 9031314 <br /> <br />CON'I'RACI'OR. NO. <br />BRADLEY, KELLY <br />1550 'I'UIVIALO DR SE <br /> <br />ARCHITEC'I'/¢NGiNEER, NO. <br /> <br />PHONE; '749-2864 PHONE= <br /> <br /> ~IE~ qUANTiTY ~DUN'~' <br />BUiLOiNG FEE $68.50 <br />PL~ REViEN <br />BUILDING STATE ~URCHAR~E $3.43 <br /> <br />I'OTALAfS~EO FEES <br />PREVIOUS RSCEiPT$ <br />THiS RECEIPT <br /> <br /> $o.oo <br />$116.46 <br /> <br />8AL,ANCE ~E $0.00 <br /> <br /> 33069 <br />CHECK ~: O <br /> <br />PAYEE: BRADLEY, KELLY <br />RECEIVED BY: PR tYPE: ~N <br /> <br />:¢ 'rHiS IS NOT A PEC~4iT, THI3 APPLICATION:Iv~JS'F GO THROUEH A REVIEW PROCEEd5' HHERE 'FH~ <br />FOLLL~ZNG rcfd~T B.c C0fflPLETED:~ i~ THE R~.[BZLZTY OF THE APPL[~T 'TO ~RE THAT <br />ALL NEC~ARY [NEO~'F[~ H~E~ p~iO~O. <br /> <br /> ~P'I' ~C: ~Y ............................................. ~'~'~ ........................................... <br /> <br /> ZONING: BY DATE SETBACk: FR / ~ / ~ / RR / SP <br /> R~R~: z~STAE~T'I~ OF'"PRE=F~"'PA~N'r B~'f'H &"E~RE BARRIER .................... <br /> <br /> HEi~'f': TOTAL ~ FT: 2000 STORI~: ] PL~.ACI'[~: <br /> <br />CiTY JURISDIC'f'[ON: BY ............................... BATE ........................ <br /> <br />FORM # MC 15-56 REV, 4/90 OFFICE COPY <br /> <br /> <br />